A Treatise on Fractures, Luxations, and Other Affections of the Bones — John Shaqi
A Treatise on Fractures, Luxations, and Other Affections of the BonesDesault, P.-J. (Pierre-Joseph)
Science
A Treatise on Fractures, Luxations, and Other Affections of the Bones
Desault, P.-J. (Pierre-Joseph)
Dislocations; Fractures; Surgery
Let the lower jaw be now brought into perfect contact with the upper
one, and not separated from it during the first few days after the
injury, except so far as may be necessary for the admission of
nourishing broths. Should a tooth have been lost, the space which it
occupied will furnish, without disturbing the bone, an opening for the
conveyance of nourishment to the patient. Let talking, laughing, and
every thing that might produce a separation between the body of the
bone and the condyle, be carefully avoided. The further treatment of
the accident should be such as is generally applicable to all fractures
of bones, and need not be at present particularly detailed.
The following cases, reported by citizen Giraud, second surgeon to the
Hotel-Dieu, will confirm the advantages of this mode of treatment.
CASE I. Margaret Bessonet, aged thirty-four, was admitted into the
hospital on the 10th of May, 1791. On the preceding day she had
received a violent fall on her chin: a severe pain, and a preternatural
mobility in the left side of the jaw, had been the immediate
consequences of the accident: from these symptoms, taken in conjunction
with those formerly mentioned (3), Desault discovered that a fracture
of the condyle existed, which he reduced and supported in the usual
manner (7).
After being somewhat uneasy during the first few days, the patient
became reconciled to the action of the bandage, which, by inattention,
had been two or three times disturbed and put out of order, but which,
by being carefully reapplied, and aided by the necessary precautions
(8), restored to the bone its natural form and solidity, by the
thirtieth day, and on the thirty-sixth the patient was discharged
perfectly cured. The only inconvenience she experienced, was a slight
difficulty in the motions of the jaw, an effect naturally resulting
from the long continued inactivity of the muscles, but which was soon
removed by means of exercise.
CASE II. Claudius Laurat, aged twenty-seven, fell as he was carrying
a heavy burden. In his fall his chin struck with violence against a
beam that lay in his way. In an instant he experienced a sharp pain
in his right temple, and found it almost impossible to move his jaw.
Two hours afterwards a considerable swelling appeared in the part,
extending from the angle of the jaw above the ear. The patient was
admitted into the Hotel-Dieu, where the circumstances of the fall and
the symptoms that followed, gave satisfactory evidence of a fracture of
the condyle. It was reduced and supported as in the preceding case. On
the day following, the swelling was removed, doubtless by means of the
compression which had been made on it; the other symptoms (3), hitherto
scarcely perceptible, became more obvious; the bandage was reapplied,
and the disease terminated, in about twenty-nine days, in the same
manner with that of case 1.
MEMOIR II.
ON THE FRACTURE OF THE CLAVICLE.
§ I.
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