the parts perfectly at rest, and the case seemed to be going well ; but on the 20th of February the upper fragment was found to be dead, and was removed.
March 31st, 1866, there was no union, and a second op- eration was performed. The cavity in the lower fragment was found to be filled up, and the wire was still firm : but the upper fragment was free. The periosteum having been scraped back from both, a piece was sawn from the lower, If in. in length, and the same in diameter ; rough toward the end, and pointed upon one side. The portion sawn from the upper fragment was 1^ in. in length, in. in di- ameter, and quite pointed at the extremity. Holes were then drilled, and the fragments were wired together, but not tightly.
On the 28th of April there seemed to be some stiffening ; but on the 10th of June he fell upon his elbow, and broke his arm again ; and on the 15th of July he left the hospi- tal.
Jan. 12th, 1867, he was readmitted ; there being no union, and on the same day a third operation was per- formed. The ends of the bones were much roughened ; and there was great difficulty in everting the fragments, and detaching the periosteum, on account of their shortened condition. One inch and three-fourths, however, were re- moved from the lower fragment, and it was 2 in. in diame- ter where cut across. The upper fragment was of normal size, but with fatty degeneration of the interior, and from this one inch was cut off. The bones were then drilled and wired, and a towel was placed in the axilla to keep out the upper fragment. On the 13th there was almost complete paralysis of the extensors of the fingers, though no nerve was known to have been divided.
The parts being kept in good position, there was slight stiffening on the 6th of February ; and on the 16th of April, the humerus being quite firm, the forearm could be flexed, and the arm raised freely from the side. The next week he left the hospital. July 3d he returned to have the wire removed, and the union was firm ; but the paralysis continued.
Dr. B. remarked that at the time of the first operation,
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