=Treatment.=--A dislocation of one side of the jaw is treated in the
same manner as that of both sides.
The dislocation may sometimes be reduced by placing a good-sized cork
as far back as possible between the back teeth of the upper and lower
jaws (on one or both sides, according as the jaw is out of place on
one or both sides), and getting the patient to bite down on the cork.
This may pry the jaw back into place.
The common method is for the operator to protect both thumbs by
wrapping bandage about his thumbs, or wearing leather gloves, and
then, while an assistant steadies the head, the operator presses
downward and backward on the back teeth of the patient on each side of
the lower jaw with both thumbs in the patient's mouth, while the chin
is grasped beneath by the forefingers of each hand and raised upward.
When the jaw slips into place it should be maintained there by a
bandage placed around the head under the chin and retained there for a
week. During this time the patient should be fed on liquids through a
tube, so that it will not be necessary for him to open his mouth to
any extent. (See Fig. 29.)
=DISLOCATION OF THE SHOULDER.=--This is by far the most common of
dislocations in adults, constituting over one-half of all such
accidents affecting any of the joints. It is caused by a fall or blow
on the upper arm or shoulder, or by falling upon the elbow or
outstretched hand. The upper part (or head) of the bone of the arm
(humerus) slips downward out of the socket or, in some cases, inward
and forward. In either case the general appearance and treatment of
the accident are much the same. The shoulder of the injured side loses
its fullness and looks flatter in front and on the side. The arm is
held with the elbow a few inches away from the side, and the line of
the arm is seen to slope inwardly toward the shoulder, as compared
with the sound arm.
The injured arm cannot be moved much by the patient, although it can
be lifted up and away from the side by another person, but cannot be
moved so that, with the elbow against the front of the chest, the hand
of the injured arm can be laid on the opposite shoulder. Neither can
the arm, with the elbow at a right angle, be made to touch the side
with the elbow, without causing great pain.
=Treatment.=--One of the simplest methods (Stimson's) of reducing this
dislocation consists in placing the patient on his injured side on a
canvas cot, which should be raised high enough from the floor on
chairs, and allowing the injured arm to hang directly downward toward
the floor through a hole cut in the cot, the hand not touching the
floor. Then a ten-pound weight is attached to the wrist. The gradual
pull produced by this means generally brings the shoulder back into
place without pain and within six minutes. (Fig. 30.)
[Illustration: FIG. 30.
TREATING A DISLOCATED SHOULDER.
(REFERENCE HANDBOOK.)
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