_Lower Jaw._—Manipulate the parts into their normal position and mould
a splint of gutta percha, or other material, as accurately as possible
to the lower jaw. If a tooth is loose and prevents the two jaws meeting
properly it should be taken out.
Apply the splint and keep it in position by a bandage, which should be
split at the chin so as to encircle the point of the jaw; the ends of
the bandage are also split as far forward as the angle of the jaw; two
ends are tied behind the neck and two over the top of the head, as in the
diagram, and these tied ends should be united by a bandage or tapes to
keep them in position (Fig. 8).
In the absence of suitable material for making a splint, this bandage
alone will have to suffice.
[Illustration: FIG. 7.
FIG. 8.]
The patient must be fed on slops through a tube passed behind the teeth,
or through a passage resulting from the loss of a tooth.
_Compound Fractures._—Clean up thoroughly as described in the treatment
of wounds. Wash out with an antiseptic solution, dust with iodoform,
apply an antiseptic pad. Set the limb in such a manner that the wound can
be dressed daily without interfering with the splints.
If the bone is protruding through the wound, it must, if possible, be got
back into position. If this cannot be done it may be necessary to saw off
the end of the bone to enable the wound to be closed.
If the wound is large, deep, or dirty, it should be stuffed with
antiseptic gauze so that free drainage may be allowed, and the gauze
should be changed each day.
_After-treatment of Fractures._—Gentle movements may be cautiously
begun, in the joints above and below the injury, in about three weeks.
While these are being carried out, the limb must be firmly supported to
avoid interfering with the healing processes going on between the ends of
the bones.
_Dislocations._
Dislocations nearly always require skilled aid to reduce them.
_Shoulder-joint._—Patient cannot raise the arm to his head or perform any
other shoulder movements freely. The shoulder is flattened, the elbow
sticks out, and the limb is usually lengthened.
_Treatment._—The patient should lie down. The operator removes his own
boot on the same side as that of the patient’s dislocation, inserts his
heel into the patient’s armpit and draws the arm steadily down, at the
same time pressing the heel in an outward direction; the dislocated
bone should slip back into its proper position. Put a pad in the armpit
and bandage the arm to the side for a week; support arm in a sling for
another week or two.
_Elbow-joint._—Dislocation of the bones of the forearm backwards at the
elbow-joint is fairly common.
Public-domain text, read in full here on John Shaqi.
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