. Injuries and diseases of the jaws : the Jacksonian prize essay of the Royal College of Surgeons of England, 1867. s singular and small fragment projected inwards and slightly upwardsinto the cavity of the mouth. The large fragment rode thesmall one, having retreated downwards and backwards, andits extremity, which was somewhat pointed, could be feltexternally under the integument. In double fractures of the body of the jaw, one being oneach side of the median line, the displacement is necessarilygreater, since tlie muscles attached to the chin tend to drawthe central loose piece d
. Injuries and diseases of the jaws : the Jacksonian prize essay of the Royal College of Surgeons of England, 1867. s singular and small fragment projected inwards and slightly upwardsinto the cavity of the mouth. The large fragment rode thesmall one, having retreated downwards and backwards, andits extremity, which was somewhat pointed, could be feltexternally under the integument. In double fractures of the body of the jaw, one being oneach side of the median line, the displacement is necessarilygreater, since tlie muscles attached to the chin tend to drawthe central loose piece downwards and backwards towardsthe hyoid bone, whilst both lateral portions are drawn for-wards and outwards, as described in the previous , as is probably the case in most instances of thekind, the obliquity of the fracture is the same on the twosides—, at the expense of the outer surface of both ex-tremities of the central fragment, no difhculty is experiencedin reducing the fracture, and it is only necessary to see thatthe posterior fragments are sufficiently approximated to the Fig. central portion ; but when, as in specimen 2 of Kings College,the obliquity is different on tlie two sides, the fracture beingat the expense of the outer plate of the posterior fragmenton the right side, and the reverse on the left side (consequentno doubt ujjon the blow having been struck to the left of themedian line), it is obvious that great difticulties will be en- DOUBLE FRACTURE OF THE JAW. 11 J. ? countered both in reducing and maintaining the apposition of the fragments, as indeed was the case with the patient inquestion. Malgaigne records an ahnost similar case in which reduc-tion could not he effected. The middle fragment, whichwas strongly drawn downward and backward, was easilybrought forward nearly to a level with the other two, Ijutwhen it came close to that on the riglit side it seemed tocatch against its posterior surface, as is seen in the figure(fig. 2
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