. Manual of operative surgery. ^qto Koo iiich downwards and deviate a little in the direction of the anchylosedside, because of a slight sliding forwards of the mandibular articulation on theunafifected side as the muscles of the neck are put on tension in the effort madeto open the Fig. 112.—The pediclcd fascia and fat flap is dissected out Irom the temporal fascia, and thefree end of the flap is turned inward between the divided ends of the mandible and suturedsecurely in place with tacking stitches. {Murphy.) 3. A sliding motion on the unaffected side can be felt by the palpating fi
. Manual of operative surgery. ^qto Koo iiich downwards and deviate a little in the direction of the anchylosedside, because of a slight sliding forwards of the mandibular articulation on theunafifected side as the muscles of the neck are put on tension in the effort madeto open the Fig. 112.—The pediclcd fascia and fat flap is dissected out Irom the temporal fascia, and thefree end of the flap is turned inward between the divided ends of the mandible and suturedsecurely in place with tacking stitches. {Murphy.) 3. A sliding motion on the unaffected side can be felt by the palpating fin-gers, and the muscular activity on that side is very much greater on attemptedopening of the mouth than on the anchylosed side. 4. The muscles on the anchylosed side are more atrophied than those onthe unaffected side. L. W. Arlow* finds that in severe cases of temporo-maxillary anchylosisthe pathological changes are by no means limited to the joint, but that osteitis * Ref. Centralblatt f. Chir., 1903, No. 28. ANCHYLOSIS 107 alters the form, size, and relations of the articular process, the coronoid process,the incisura semilunaris, the zygoma, etc. As a consequence simple divisionof the articular process is insufficient to give motion, and even when combinedwith osteotomy of t
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