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Fractures of the Lower Jaw.Symptoms*-This condition is easily recognized by the unnatural movement of the fragments. By placing the fingers over the painful spot, we can easily detect a grating upon slight movement; and upon looking into the mouth we can usually see the fissure in the bone. The teeth, also, are displaced, and some of them are often loosened. The jaw is usually turned toward the injured side. Treatment.-The treatment of a fracture of the lower jaw is extremely troublesome, especially if the bone be broken at the side, as is usually the case. The difficulty lies in keeping the fragments at rest. Many dressings have been employed in the treatment of fractures of the jaw. The two measures which are of most value are a splint on the outside of the jaw and a wire to pass between the teeth. The splint should be made of felt, pasteboard, gutta-percha, or glue. These should be fitted to the jaw in the way described in discussing dressings in general. The splints should pass around the entire jaw from ear to ear, and should extend under the chin from side to side. After it has been fitted, it is held in place by a bandage which passes around the head and under the jaw. Dr. Hamilton, of New York, uses for the dressing of a fractured jaw a strong leather strap. This passes under the chin and buckles over the top of the head. It is held in place by another strap which passes around the head above the ears and across the forehead. A third strap is attached to the last-named at the back of the head and passes over the crown to be attached to the strap which runs under the jaw. In using this apparatus care should be taken not to buckle the straps too tightly. This contrivance answers exceedingly well in many cases. It is generally advantageous to hold the two fragments close to each other by twisting a wire around the two teeth which are nearest to the break in the bone. For this purpose, a silver wire is used. If the teeth be sound and firm, considerable force can be employed in this way in holding the fragments in position. If none of these methods be employed, a reasonably good dressing can be made by applying two bandages. A strip of muslin or sheeting, three feet long and six inches wide, is prepared for this purpose. At the middle of it, and about three-quarters of an inch from one edge, a slit is cut, long enough to permit the chin to pass through it. The ends of this slit should be stitched so that it will not tear when applied. This is then arranged so that the chin projects through the opening, while the ends of the bandage are made to meet behind the head. Another strip is then passed at right angles to this, running under the jaw and over the top of the head. The two may be then tied together by another bandage, which passes from the knot at the back of the neck to the one at the top of the head. Whatever dressing be employed, it is important that the patient should himself use every effort to prevent movement of the fragments ; for none of these dressings are so perfect as to permit free movement. To further this object, the patient should have liquid food only - milk, broth, etc. Difficulty is sometimes experienced in introducing food without opening the mouth. Most persons have some defect in the teeth through which a straw can be readily introduced, and the liquid thus sucked into the mouth. In other cases, a sound tooth has been extracted to afford an opportunity for introducing the straw. In order to avoid such a sacrifice of a sound tooth, surgeons sometimes place a thin piece of cork, shaped like a wedge, between the upper and lower jaw, at the seat of fracture. This should have a groove above and below, so that it will be held firmly by the teeth. In this way the jaws are held apart so that food can be readily introduced. But first, if you want to come back to this web site again, just add it to your bookmarks or favorites now! Then you'll find it easy! Also, please consider sharing our helpful website with your online friends.
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