Step 2. Bend the arm to a right angle with the thumb upwards. An assistant next reduces the fracture, and holds it in position. Then apply the splints. When adjusting the inside splint, care must be taken that the internal condyle is eased from pressure by sufficient padding above and below it. Next fasten on the splints by a roller begun at their lower end, leaving the hand free, and carried up to the elbow. Before turning round that joint a soft pad must be placed in the hollow of the elbow to push the lower end of the humerus back, and the length of the arm should be measured against the unbroken one to make sure that the shortening is reduced. Extension is kept up the whole time the splint is being fixed to the arm, which is done by carrying the roller round the elbow with figures of 8 and simple spirals up to the axilla, where it is finished off. Step 3. Lastly, the forearm is supported in a sling under the wrist, leaving the elbow free (as in fig. 35, page 52). After three weeks of complete immobility, passive motion should be applied to the elbow daily, during a fortnight or three weeks more in which the splint is still worn. If the displacement returns very easily, it is better to use an L-shaped splint passing behind the arm and below the forearm. This may be made of wood, or of leather, or of gutta-percha, in the mode about to be described. The =L-shaped splint= of gutta-percha, or leather, is made as follows:— _Apparatus._—1. Sheet gutta-percha ¼ inch thick. 2. A tray or wide wash-hand basin. 3. A basin of cold water. 4. A kettle of boiling water. 5. A towel. 6. A knife. 7. A sheet of newspaper. Cut a pattern of paper reaching, while the elbow is bent and the thumb upwards, from the arm-pit down the back of the arm and under the elbow and forearm to the wrist. The sides must be brought forward to the biceps and front of the forearm as seen in fig. 34. Next cut from the sheet of gutta-percha a piece to match the pattern. Prepare the tray with the hot water, lay in it the towel, and then soften the gutta-percha by laying it in the tray and covering it with almost boiling water, adding more water as the first cools; this may be done by an assistant, while the surgeon directs another assistant to grasp the forearm and reduce the fracture. The assistant keep extension while the surgeon lifts the softened gutta-percha with the towel from the hot and plunges it a moment into cold water, then lays it on the limb, which the assistant keeps at a right angle, and the bone in place, while the splint is setting to the limb. This done, the splint is removed to be trimmed, perforated, and covered with wash-leather. It is then ready for use. [Illustration: Fig. 34.—Gutta-percha Splint for fracture at the lower end of Humerus.]