Treatment.—Apparatus.—1. A towel.
2. A four-tail bandage.
Fig. 60.—Dislocation of the jaw.
The patient should be seated in a high-backed chair, resting his head against the back. The surgeon winds the towel round both thumbs, and standing immediately in front of his patient, places a thumb on the second molar of both sides, if the dislocation be double, or on one side only, if that be alone displaced (see fig. 60). He then presses steadily downwards until the condyle is released, when it slips back to its place. The return of the bone may be aided by pushing up the chin with the fingers after the ramus of the jaw has been lowered.
When the jaw is replaced, a four-tail bandage or split handkerchief should be tied over the nucha and vertex of the head, to keep the jaw closed (see fig. 23, page [32]). Biting or chewing should not be attempted for ten days or a fortnight. The patient should be warned also that when the jaw has been once dislocated it very readily slips out of place again; he must thenceforth avoid gaping or opening the jaw very widely.
The Clavicle is rarely dislocated, nevertheless both the inner and the outer end may be displaced. The signs are obvious—the end of the bone is felt in its new position. The treatment for all is the same.
Apparatus.—1. Roller, 2¼ inches wide.
2. A piece of old blanket.
The blanket should be torn into strips about a foot square, and folded thrice, thus making a long soft pad to line the axilla, one for each armpit. The patient is next seated on a stool; an assistant standing behind, draws back the shoulder while he presses on the spine with his knee; the dislocation being reduced, the surgeon fixes the bone by a figure of 8 carried round the shoulders and across the back. The forearm is then bent and fastened to the body by a few turns of the roller round it and the chest. This prevents the pectorals from acting on the bone. The apparatus may be laid aside at the end of a week, but the arm must be fixed to the trunk for a fortnight longer.