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H. C. Masland, M.D.
JAMA. 1924;83(20):1608. doi:10.1001/jama.1924.02660200060032.
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To the Editor:  —In The Journal, November 1, is a paper with this title by Orr and Thomson, that was read before the Section on Orthopedic Surgery. It advocates and illustrates the correction of deformity in compound fractures by traction through the os calcis. This proposition seemed to have the approval of those who entered into the discussion. Such a presentation should not go to the profession at large without a challenge. The effect of such traction is to bend the foot first and then, when the ankle joint ligaments prevent further flexure, to transmit the power to the tibia and fibula at an angle. Should the ankle joint be immobilized in plaster of Paris, then the power is transmitted directly to the shafts of the leg bones at an angle. The inevitable result is a tilting of the lower fragments posteriorly to the upper. Only in those fractures in


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