A New Apparatus for the Treatment of Frac- 
ture of the Inferior Maxilla. 
Paper read before the Colorado State Medical Society, June 23, 1894. 
CLAYTON PARKHILL. M.D. 
PROFESSOR OF THE PRINCIPLES AND PRACTICE OF SURGERY AND CLINICAL 
SURGERY IN THE UNIVERSITY OP COLORADO; SURGEON TO ST. LUKE’S 
AND ARAPAHOE cdUNTY HOSPITALS, ETC., ETC. 
REPRINTED PROM 
THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION 
SEPTEMBERT^T^Sf 
American Wepical Association Press/ 
OHIcIgO; 
1894. A NEW 
APPARATUS FOR THE TREATMENT 
OF FRACTURE OF THE INFERIOR 
MAXILLA 
Last October I was consulted by Mr. C., who gave 
the history of having been sandbagged the night 
before. The right side of his face and the parotid 
region presented evidence of serious contusion. The 
mouth was open and fixed, giving him the appearance 
of having a dislocation of the jaw. The incisors 
were separated about three-quarters of an inch, the 
posterior molars being in contact. There was no 
lateral displacement. On examination under an 
anesthetic, I found a fracture of the neck of the jaw. 
Crepitus was marked. There was apparently no dis- 
placement of the upper fragment. Reduction was 
effected very easily, the teeth coming into perfect 
articulation. A gutta-percha splint was molded to 
the jaw, and attached by tapes to a cap covering the 
head, making an apparatus similar to what is known 
as the French Dressing. 
No sooner had the influence of the anesthetic 
passed away than the deformity returned. I then 
applied in turn the various bandages which have been 
recommended, only to be met by failure with each 
one. 
On the following day I requested Dr. H. P. Kelly, 
an expert dentist of this city to see him with me, 
and make a model for an inter-dental splint. It was 
found impossible to separate the molars sufficiently 
to get the plastic material between them. I then 
applied the Hamilton Dressing, only to suffer another 
defeat. 
It was evident that the displacement was due to the 
action of the temporal and masseter muscles on the Fig. 1 Fig. 2. 4 
Fig. 3. Fig. 4, side affected, and that a dressing capable of holding 
the jaw in place must be one having an upward and 
forward pressure, antagonizing this force. 
I had the Denver Surgical Instrument Company- 
make for me the apparatus shown in the accompany- 
ing cuts. The corset is made of heavy leather and 
has a socket fitted in it at the back to receive the 
spring. The spring is in shape similar to the ordinary- 
jury-mast, and is made of steel. It has attached to 
it an inter-scapular pad and an occipital pad. On its 
anterior extremity there is an adjustable ring fastened 
by a set screw. This is intended to regulate the 
tension by shortening or lengthening the spring. 
The jaw-piece is made of copper, molded to the 
shape of the maxilla. The horizontal and vertical 
tapes attached to the jaw-piece posteriorly are self 
explanatory. The small chain attached to the jaw- 
piece anteriorly ends in a hook. This chain is in- 
tended to pass through the sliding ring, and when 
the proper tension is attained, to hook back into one 
of its own links. 
This apparatus was applied with the patient under 
an anesthetic. The deformity was completely cor- 
rected, and there was never the slightest tendency 
towards its recurrence. The patient expressed him- 
self as feeling no discomfort. He removed it con- 
trary to my directions at the end of twenty-one days. 
I had intended that he should wear it four weeks. 
The result, however, was perfect. 
A fracture through the neck of the jaw, is a very 
rare injury, but I believe this apparatus will prove 
equally good for other forms of fracture of that bone. 
I propose to have made another jaw-piece which will 
extend upward around the maxilla and afford a lateral 
support. With this addition I think the instrument 
will apply as well to either simple or multiple frac- 
tures of the body of the bone, as it does to the neck. 
The results obtained in fracture of the lower jaw 
are far from satisfactory in many cases. Within the 
last three years I have operated on three cases which were sent to me suffering from ununited fracture. 
This number of failures to get union in a fracture of 
no greater frequency seems to me to indicate that 
present modes of treatment are not entirely satis- 
factory, and affords me encouragement to present 
this new method of treatment to the profession for 
its approval.