Step 1. Cut out a paper pattern of the splint on the limb to be fitted. The pattern should reach along the clavicle to the root of the neck, and over the scapula to its posterior border, and be continued down the arm to the elbow, tapering as it goes, but having its anterior and posterior margins brought sufficiently to the inner side of the arm to give the splint a good grasp of the limb in descending. The end should be left long enough to turn a couple of inches round the point of the elbow (see fig. 36). A notch must be cut at the upper end of the paper pattern to make it fit on the shoulder between the clavicle and the spine of the scapula; this should not be repeated in the gutta-percha, as that can be moulded on without; and for that reason the cap is much more serviceable when made of gutta-percha than of leather, where a notch must be cut and stitched together when the leather is set. The gutta-percha, when cut to pattern, must be softened in the manner described in making the splint for the elbow at page 50, fig. 34; then accurately adjusted to the shoulder as high as the root of the neck, and turned under the point of the elbow a couple of inches (see fig. 36), while the forearm is well raised across the chest. [Illustration: Fig. 36.—Cap for fracture near the Shoulder.] When set, the splint must be removed that it may be trimmed and lined with wash-leather. If of gutta-percha, it must be perforated with small holes; if of leather, the notch at the shoulder must be stitched together. Next prepare a soft thin pad, 5 or 6 inches broad, and 8 or 10 inches long, to fill the axilla. Step 2. Bandage the fingers and thumb separately, then, putting a little wool in the palm and round the wrist, bandage the hand and forearm to the elbow, where the bandage is fastened. Step 3. Apply the splint. First get on the cap; then put the soft pad in the axilla, filling it out if the arm-pit is very hollow with cotton wool, and bend the elbow till the hand lies on the breast of the opposite side. Then, while an assistant holds the limb and apparatus in position, fasten them all in place by continuing the roller of the forearm in figures of 8 round the elbow until the splint is well fixed to it; and carry the roller up the arm by reverses to the axilla. Step 4. A little wool or piece of flannel having been placed in the opposite arm-pit to prevent chafing, a spica for the shoulder is then applied (see page 16), beginning at the root of the neck and working downwards. Careful extension is continued by the assistant all the time this bandage is being put on, until the head of the bone is well drawn into the cap. [Illustration: Fig. 37.—Fracture at the upper end of Humerus. The apparatus completed.] Step 5. The arm is drawn to the side, and the forearm fixed against the chest by a roller carried round the arm and trunk and over the shoulder (see fig. 37).