Principles.
—Smillie578 introduces his discussion of the stiff knee in fracture of the femoral shaft with a comment on the complex development of this joint. He attributes stiffness to adhesions in the joint, in the capsule or in the quadriceps, and states that powerful traction is the most important contributory factor. He condemns the use of skeletal traction for reduction, feeling that it should really be used only for maintaining reduction. He does not approve the use of skeletal traction for more than three weeks. If traction is absolutely necessary through the condyles he prefers a Steinmann pin to a Kirschner wire because it causes less reaction and because it is driven in and fits tighter. Actually he prefers skeletal traction through the upper part of the tibia. [ED. Note.—Even the Steinmann pin should have a drill point of a cutting or "bayonet" type and should be drilled.