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The Use of Pneumatic Pads in the Treatment of Ununited Fractures of the Humerus.

THE principle of the use of a slowly acting force to reduce a malposition or deformity is an important one in orthopaedics. Such a force is most often used in the form of a fixed splint. When some degree of reduction has been thus obtained a readjustment of the splint is carried out, so that the force which has diminished or ceased to act is brought to bear again; that is to say, a readjustment or often a replacement of the apparatus is necessary in order to " recharge the recoil spring." It appears to me that in some cases the use of pneumatic pressure could effectively add to the reducing force and increase its range of action. I first used pneumatic pads in 1913, in conjunction with corrective plaster jackets applied according to the Abbott method. The air pad replaced the felt packing between the jacket and the prominences it was desired to reduce. This application of pads was certainly effective, and considerably increased the amount of reduction which could be effectively carried out by one jacket. The pads were made from sections of motor inner tubes of a diameter of 2to 4i in. Convenient lengths were from 3 to 9 in. The ends of the tubes were vulcanized, and an ordinary bicycle tyre valve was set in at a convenient position. The tube was enclosed in a fabric case of such a size as to limit its undue expansion when inflated. Pads made in this way by a competent tyre mechanic retain pressure up to 20 to 30 lb. to the square inch, in the same degree as a bicycle tyre. These pads