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Pinned elbow fracture, X-ray. Metal screws (upper centre, white) and a metal plate (white) have been surgically implanted to hold a fractured upper arm bone (humerus) together. The fracture is seen just above the two longer screws. The pinning is needed to hold the bone fragments together in the correct alignment as the bone heals. The elbow (centre) is the joint where the humerus joins to the two lower arm bones (radius and ulna, lower right). A row of staples (white) runs over the elbow. They join the edges of the surgical wound, made when pinning the bone, allowing the skin to heal. For X-rays of the elbow before pinning and from a different angle, see images M330/1065 and M330/1067. (KEYSTONE/SCIENCE PHOTO LIBRARY/MAURO FERMARIELLO/SCIENCE PHOTO LIBRARY)