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A method for treating the fracture of the neck of the condyle
A RIETHOD FOR TREATIXG THE FRACTIIRE OF TIIE NECK OF THE COND‘S'L,K
C ASE (E. G. B.) NO. 508, W. M.
Age 29. _4ccitlcnt 1\Z:rrch 27, 1925. of sheet iron which Bislo~g.-The pat,ictnt fell forward &liking his chin on :I piece He suffered from severe pain in his head, hemorrhage and was being pushed by him. He was x-rayed by a physician for the pain, and was unable to hear in the right ear.
Fig.
Fig. 2.-Fracture with displacement. obtainable alignment.
l.--SntermaxiIla~J-
of the condyloid Approximation, and
splints
neck best
with
Fig.
stilts
i.-X-r33.v,
insurance company, with negative report as to fracture. hospital, and the patient was under observation for three with negative report as to fracture. Patient was discharged 84
in
place.
Interal
after’
treatment.
The case was referred days. He was x-rayed from hospital. He
to the again, reported
Fig. Jag. Fig
Fig.
Fig. 4. Fig. 5. Fig. 4.-Illustration of fracture of condyloid neck with displawmmt of 5.-With stilts in place to afford :~ppr’oxinlation and stability. 6.---Closed, after union, to carry ht~+rl bxck into thr- ~lmoi~l cw\,ity.
8.-X-ray,
anterior posterior, before treatment.
of left
side,
Fig.
R.-X-ray,
anterior posterior, after treatment.
6.
the
htnd
of left
sirl?.
86 to his placed
A. L’. Russell dentist mandible,
to
have fractured the patient was
teeth referred
restored. to me
for
Because of diagnosis.
lack
of
occlusion
Exarnina.tion.-April 3, 1925. Condyloid head on right side was located in right ear. Crepitation was present upon movement. Ro condylnr head left could be demonstrated. There was some swelling and soreness. The displaced to the right with little or no occlusion of the teeth. Radiographic exnminntion revealed fracture of the left eondyle neck and inward displacement of head. Fracture of tympanic plate could not onstrated by x-ray, but was present.
from
dis-
by palpation movement on mandible was with upward be well dem-
Recoltlntetldutir,t(.-Reduction of fracture by intermaxillary splints with stilts. (The st,ilts were to be used to stabilize the mandible aud to produce better alignment of fracture and to move the condyloid head forward out of the fractured tympanic plate.) The patient, was referred by the physician to be x-rayed again, and fracture of condylc neck on left side and fracture of tympanic plate right side \vere reported. Dental consultation was called, no treatment recommended becausr the opinion was given that “treatment will not be beneficial, and if treated l’aticnt will have a stiff jaw due to the fractured tympanic plate. ’ ’ The patient came back to me. My above recommendation was carried out. (Fig. 1.) Intermaxillary splints were constructed and cemented to place. (Fig. 3.) X-ray showed fractured ends approximatiug but not in perfect alignment. (Fig. 3.) Three weeks later stilts were removed and rubber bands applied to assist the teeth and jaws to assume former relatiou. Usual st,ifYness due to disuse, occlusion good. Fig. 4 illustrates fracture of the condyloid ueck nith displaced head. Fig. 5 shows stilt in place allowing enough approximat,ion for union. Fig. G shows stilt removed, mouth closed which carries head into the glenoid cavity. Use assists the head to assume its normal position and good alignment. (Fig. 7.) After treatment good alignment. (Fig. 8.) Anterior posterior x-ray shows fracture and displacement. (Fig. 9.) After treatment. The x-rays were mntlc as nearly as possible at right angles to show the alignment from two positions.
l
C ASE (E. G. B.) NO. 508, W. M.
Age 29. _4ccitlcnt 1\Z:rrch 27, 1925. of sheet iron which Bislo~g.-The pat,ictnt fell forward &liking his chin on :I piece He suffered from severe pain in his head, hemorrhage and was being pushed by him. He was x-rayed by a physician for the pain, and was unable to hear in the right ear.
Fig.
Fig. 2.-Fracture with displacement. obtainable alignment.
l.--SntermaxiIla~J-
of the condyloid Approximation, and
splints
neck best
with
Fig.
stilts
i.-X-r33.v,
insurance company, with negative report as to fracture. hospital, and the patient was under observation for three with negative report as to fracture. Patient was discharged 84
in
place.
Interal
after’
treatment.
The case was referred days. He was x-rayed from hospital. He
to the again, reported
Fig. Jag. Fig
Fig.
Fig. 4. Fig. 5. Fig. 4.-Illustration of fracture of condyloid neck with displawmmt of 5.-With stilts in place to afford :~ppr’oxinlation and stability. 6.---Closed, after union, to carry ht~+rl bxck into thr- ~lmoi~l cw\,ity.
8.-X-ray,
anterior posterior, before treatment.
of left
side,
Fig.
R.-X-ray,
anterior posterior, after treatment.
6.
the
htnd
of left
sirl?.
86 to his placed
A. L’. Russell dentist mandible,
to
have fractured the patient was
teeth referred
restored. to me
for
Because of diagnosis.
lack
of
occlusion
Exarnina.tion.-April 3, 1925. Condyloid head on right side was located in right ear. Crepitation was present upon movement. Ro condylnr head left could be demonstrated. There was some swelling and soreness. The displaced to the right with little or no occlusion of the teeth. Radiographic exnminntion revealed fracture of the left eondyle neck and inward displacement of head. Fracture of tympanic plate could not onstrated by x-ray, but was present.
from
dis-
by palpation movement on mandible was with upward be well dem-
Recoltlntetldutir,t(.-Reduction of fracture by intermaxillary splints with stilts. (The st,ilts were to be used to stabilize the mandible aud to produce better alignment of fracture and to move the condyloid head forward out of the fractured tympanic plate.) The patient, was referred by the physician to be x-rayed again, and fracture of condylc neck on left side and fracture of tympanic plate right side \vere reported. Dental consultation was called, no treatment recommended becausr the opinion was given that “treatment will not be beneficial, and if treated l’aticnt will have a stiff jaw due to the fractured tympanic plate. ’ ’ The patient came back to me. My above recommendation was carried out. (Fig. 1.) Intermaxillary splints were constructed and cemented to place. (Fig. 3.) X-ray showed fractured ends approximatiug but not in perfect alignment. (Fig. 3.) Three weeks later stilts were removed and rubber bands applied to assist the teeth and jaws to assume former relatiou. Usual st,ifYness due to disuse, occlusion good. Fig. 4 illustrates fracture of the condyloid ueck nith displaced head. Fig. 5 shows stilt in place allowing enough approximat,ion for union. Fig. G shows stilt removed, mouth closed which carries head into the glenoid cavity. Use assists the head to assume its normal position and good alignment. (Fig. 7.) After treatment good alignment. (Fig. 8.) Anterior posterior x-ray shows fracture and displacement. (Fig. 9.) After treatment. The x-rays were mntlc as nearly as possible at right angles to show the alignment from two positions.
l