The nature and etiology of bone disease in Kashmir ; The conservative surgery of long bones ; Necrosis of the lower jaw.

  • Neve, Ernest Frederic, 1861-
Date:
[1889?]
Catalogue details

Licence: Public Domain Mark

Credit: The nature and etiology of bone disease in Kashmir ; The conservative surgery of long bones ; Necrosis of the lower jaw. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    October 1 lSth.—Doing very well: a little bare bone can still be felt at the upper anterior sinus. Dismissed. In the middle of November, when seen, there was no dis- charge whatever. In January 1888 she was quite well, and there was no deformity to be detected, except after careful examination. Here the surface of the condyle was found to be somewhat eroded, and the bone was separated from the periosteum by pus. This, again, is a case in which it will be interesting to note whether any recrudescence of the disease occurs, and whether excision of the jaw will be required eventually. I think not. Briefly stated, the advanlages of excision of the condyle in such cases as the above are, that it taps the subperiosteal pus, it gives room for effectual drainage, it is an osteotomy and re- lieves bone tension. Where ankylosis is present, it is removed while the resulting disfigurement is inconsiderable, and the usefulness of the jaw practically unimpaired. In the more seri- ous cases of threatening necrosis of the jaw, time is gained by a palliative operation, while only if persistence or return of symp- toms occur, one' is impelled to perform the graver operation of removing the jaw bone. #0 The reformation of bone after excision of jaw is a point of importance. In Case I, it will be seen that, although a certain amount of new bone was thrown out, this was subsequently ab- sorbed. This agrees with the experience of Christopher Heath, * who says : It is certain, however, that in the course of years a great, if not complete, reabsorption of new bone, thus formed, takes place. I think, however, that this statement requires qualifying. For the formation of permanent new bone depends, doubtless, upon two important points, viz., the age of the patient and the duration of the disease. As a matter of fact, the periosteum of the jaw is not nearly so forward to throw out new bone as that of the long bones for instance. Cases of necrosis of the lower jaw seldom present any great formation of bony case. * Dictionary of Practical Surgery, Vol. I, p. 834.