Applied anatomy and oral surgery for dental students . r a complete solution of conti-nuity; the result was perfect union and subsequentrestoration of function. Symptoms and Diagnosis.—Fracture of the mandiblehas the symptoms common to fractures of other bones,viz., sharp pain, crepitus, or grating on rubbing the endstogether, preternatural mobility, deformity, indicatedby malocclusion of the teeth, swelling, and impairedfunction. The pain and tenderness are much greaterthan any lesser injury. When the fracture occurs inthe portion of the jaw occupied by teeth, the line ofthe teeth may be irre
Applied anatomy and oral surgery for dental students . r a complete solution of conti-nuity; the result was perfect union and subsequentrestoration of function. Symptoms and Diagnosis.—Fracture of the mandiblehas the symptoms common to fractures of other bones,viz., sharp pain, crepitus, or grating on rubbing the endstogether, preternatural mobility, deformity, indicatedby malocclusion of the teeth, swelling, and impairedfunction. The pain and tenderness are much greaterthan any lesser injury. When the fracture occurs inthe portion of the jaw occupied by teeth, the line ofthe teeth may be irregular, the teeth anterior to the breaklying on a lower level than those posterior to it. Thisis due to the fact that the posterior fragment is held upin position by the elevator muscles, while the depressor^ Annals of Surgery. FRACTURES 247 muscles and gravity cause the anterior fragment to grasping one of the fragments in each hand theycan be made to move up and down one upon the other,which is indicated by the adjacent teeth interchanging. Mk. 57.—Kali<if,rai)h showiiiR fracture at angle of mandible (after Cryer). levels. Crepitus is also elicited in this way. In frac-tures of the angle or ramus behind the insertion of themasseter little or no deformity occurs, as the anteriorfragment is then held up by this muscle, making diagnosis 248 SPECIAL SURGERY difficult. In these cases the x-ray is useful in deciding thenature of the injury. In all cases the x-ray is valuable indetermining the direction of the fracture, injuries to rootsof teeth, involvement of teeth in the fracture, and posi-tion of the fragments after reduction (Fig. 57). Fracture of the condyloid process may be diagnosed byhistory of a blow on the opposite side of the chin, swellingand pain in front of the ear, limitation of motion, anddeviation of the chin toward the affected side when themouth is closed. It is sometimes difficult to obtain agood x-ray picture showing the injury. Fracture at thispo
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