The condition of the teeth is the most important point to observe.
Owing to displacement of the fragments there is a difference in the
level of the teeth or line of the teeth, or both, at the place where
the fracture occurs. Also one or more of the teeth are usually
loosened at this point. In addition, unusual movement of the
fragments may be detected as well as a grating sound on manipulation.
=Treatment.=--The broken fragments should be pressed into place with
the fingers, and retained temporarily with a four-tailed bandage, as
shown in the cut. Feeding is done through a glass tube, using milk,
broths, and thin gruels. A mouth wash should be employed four times
daily, to keep the mouth clean and assist in healing of the gum. A
convenient preparation consists of menthol, one-half grain; thymol,
one-half grain; boric acid, twenty grains; water, eight ounces.
[Illustration: FIG. 12.
BANDAGE FOR A BROKEN JAW (AMERICAN TEXT-BOOK).
Above cut shows a four-tailed bandage; note method of tying; one strip
supports lower jaw; the other holds it in place against upper jaw.]
=SHOULDER-BLADE FRACTURE.=
_First Aid Rule.--There is no displacement. Bandage fingers, forearm,
and arm of affected side, and put this arm in sling. Fasten slung arm
to body with many turns of a bandage, which holds forearm against
chest and arm against side._
Shoulder-blade fracture occasions pain, swelling, and tenderness on
pressure over the point of injury. On manipulating the bone a grating
sound may be heard and unnatural motion detected. The treatment
consists in bandaging the forearm and arm on the injured side from
below upward, beginning at the wrist; slinging the forearm bent at a
right angle across the front of the body, suspended by a narrow sling
from the neck, and then encircling the body and arm of the injured
side from shoulder to elbow with a wide bandage applied under the
sling, which holds the arm snugly against the side. This bandage is
prevented from slipping down by straps attached to it and carried over
each shoulder.
=ARM FRACTURE.=
_First Aid Rule.--Pad two pieces of thin board nine by three inches
with handkerchiefs. Carefully pull fragments of bone apart, grasping
lower fragment near elbow while assistant pulls gently on upper
fragment near shoulder. Put padded boards (splints) one each side of
the fracture, and wind bandage about their whole length, tightly
enough to keep bony fragments firm in position. Put forearm and hand
in sling._
In fracture of the arm between the shoulder and elbow, swelling and
shortening may give rise to deformity. Pain and abnormal motion are
symptoms, while a grating sound may be detected, but manipulation of
the arm for this purpose should be avoided. The surface is apt soon to
become black and blue, owing to rupture of the blood vessels beneath
the skin.
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