Step 3. The roller first fastens the foot against the foot-piece by figures of 8, then passes up the leg by reverses until opposite the lower hook, where it is fastened. [Illustration: Fig. 46.—Fractured Patella, drawing down the upper fragment.] Step 4. A second roller is then begun at the top of the thigh and brought down the limb till it reaches the compress over the patella; from this point it passes below the lower screw at the back of the splint and makes one circular turn round the limb; the roller is then taken upwards across the compress (as shown in fig. 46) to the upper screw, where it also makes a circular turn; having done this it again descends to reach the lower screw, and is returned as before. Each of these turns should be drawn tightly to bring the upper fragment as near the lower one as possible; when this is done the bandage is completed over the knee by figures of 8. It suffices to fix the lower fragment, which cannot be drawn up to meet the upper one; the latter must descend to it. Step 5. The limb is lastly put into position by elevating the heel and by raising the body with pillows till it is in a half-sitting position. The patient wears this splint four weeks, during the first fortnight of which the bandage should be perseveringly re-applied every three or four days until the upper fragment is brought into apposition with the lower one. After this the splint may be changed for a light starch or gutta-percha case, to be worn for six weeks more, and then replaced by a back splint of leather and knee-cap, that must not be laid aside for another period of three or four weeks. If the patient can be persuaded not to bend his knee for four months, the union of the fragments will be less likely to yield afterwards. He should be also warned that much stiffness will result from the long fixed position necessary to procure good union between the fragments; but the stiffness will all subside in time, notwithstanding the long-enforced rigidity. _Strap and Spiral Bandage._