232 OPERATIONS ON BONES. 



this lesion, renders it easy of diagnosis. The abnormal mobility 

 and the crepitation, with the pain manifested by the patient when 

 undergoing examination, are concurrent symptoms. Looseness 

 of the teeth, abundant salivation, and entire inability to grasp the 

 food complete the symptomatology of these accidents. In the 



PiQ. 256.— Fracture of the Lower Jaw. 



treatment, splints of gutta percha or leather are sometimes used, 

 but they are of difficult application. Our own judgment and 

 practice are in favor of the union of the bones by means of metallic 

 sutures. \ 



The Lower Jaw. — A fracture here is not an injury of infrequent 

 occurrence. It involves the body of the bone, at its symphysis, or 

 back of it, and includes one or both of its branches, either more 

 or less forward, or at the posterior part, near the temporo-max- 

 Ulary articulation, at the coronoid process. 



Falls, blows, or other external violence, or powerful muscular 

 contractions during the use of the speculum, may be mentioned 

 among the causes of this lesion. The fracture of the neck and of 

 the brajiches in front of the cheeks cause the lower jaw, the true 

 dental arch, to drop without the ability to raise it again to the 

 upper, and the result is a peculiar and characteristic physiognomy 

 (Fig. 256.) The prehension and mastication of food become im- 

 possible; there is an abundant escape of fetid and sometimes 

 bloody saliva, especially if the gums have been wounded ; there is 

 excessive mobility of the lower end of the jawbone ; and there is 



