The essentials of bandaging: $b including the management of fractures and dislocations, with directions for using other surgical apparatusHill, Berkeley
Science
The essentials of bandaging: $b including the management of fractures and dislocations, with directions for using other surgical apparatus
Hill, Berkeley
Bandages and bandaging; Dislocations -- Treatment; Fractures -- Treatment; Surgery, Minor
On emergency, when gutta-percha, leather, or pasteboard are not at
hand, the jaw may be set, and then kept in position by a four-tail
bandage, made from a pocket-handkerchief, until more complicated
apparatus can be prepared.
The apparatus must be worn five weeks before it is laid aside and
mastication permitted.
=Interdental Splints.=—In cases of unusual difficulty, interdental
splints may be employed. To fashion some of these, the mechanical
skill of a dentist is requisite, unless _Morel Lavallée’s plan_ is
resorted to. He applied a mould or socket to the line of the teeth,
and kept it in place by pressure underneath the jaw. He first brought
the fragments into apposition by means of threads and wire. Then he
took a piece of gutta-percha, about ⅓ inch thick and ½ inch broad,
and long enough to extend, when bent along the lower jaw, from one
wisdom molar to the other. This was softened in water, and pressed on
the teeth; next a well-padded horse-shoe plate was placed under the
chin, reaching from one angle of the jaw to the other, and two wires
were passed through the side of this plate opposite the angle of the
mouth; these were drawn through the plate by a screw nut; their upper
ends being curved into hooks with sharpened points. The points catch
into the gutta-percha; by screwing up the nuts, the chinplate was
raised, and the teeth driven up and bedded into the splint.
This method, however, has its disadvantages. If the fracture take
place behind the first molar, the bearing on the upper fragment is
too slight to keep it down in its place.
In the _New York Medical Journal_ for September and October, 1866,
Mr. Gunning, of that city, has published a mode of applying caps
fitted to the teeth for fracture of the jaw-bone. External support is
abandoned wherever it is possible. In simple fractures, the caps or
interdental splints, being accurately fitted, require no fastening to
the teeth.
The jaw should be adjusted in its splint as quickly as possible
after the accident. The fragments are first brought into their true
position. Gaps through loss of teeth at the line of fracture, are
filled by plugs of hard wood, and the fragments kept in place by
wiring the teeth together tightly. Continued strain on the teeth
causes much pain; hence all means for keeping the fragments in place
while the splint is being fitted should be removed when that is
accomplished, though ligatures used solely to support loosened teeth
may be left, as there is no traction upon them. Stumps, and teeth
loose before the accident are best taken out, if they interfere with
the arrangement of the splint.
[Illustration:
Fig. 24.—Vulcanite Interdental Splint to fit the arch of the teeth
of the lower jaw, seen upside down. The holes marked a pass through
to the upper surface, to allow water to be injected between the
splint and the teeth, while it is worn, for cleaning.
]
Public-domain text, read in full here on John Shaqi.
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