FRACTURE OF BONES 369 



ances and the presence of the wound would assist in making 

 the diagnosis. If there is doubt in regard to the exact con- 

 ditions the external wound can be opened sufficiently to 

 examine the parts direct. Compound and comminuted 

 fractures show the presence of the wound and the opening 

 through the cranial bones. Fragments of bone may be found 

 projecting out through the opening or downward into the 

 cranial cavity. Probing will reveal the conditions. The 

 concussion from the injury may produce unconsciousness 

 for a time even though but little damage has been done the 

 bones themselves. Death occurs suddenly in many instances 

 when the brain is severely injured or sudden severe hemor- 

 rhage takes place. Careful examination should be made in 

 all cases in order to establish a positive diagnosis. 



Prognosis. The prognosis should not be considered too 

 favorable on account of the danger of brain complications. 



Treatment. The treatment will depend upon the kind of 

 fracture. In simple fissuring of the bone no treatment is 

 necessary, except for the contusion of the skin and muscular 

 tissue covering the bone. Penetrating fractures are best 

 treated by opening the external wound, examining the 

 fractured portions and elevating them carefully with a scalpel 

 or stiff probe. Clean the wound thoroughly and suture the 

 skin covering it with iodoform collodion. 



Depression of the skull bones should have prompt treat- 

 ment to relieve the pressure from the brain and membranes. 

 This is best done by making external incision, and if necessary 

 a small opening through the bones so that an instrument can 

 be inserted to elevate them to their normal position. Strict 

 aseptic precautions should be observed in the operation. 

 Suture the outside wound. In compound comminuted frac- 

 tures all fragments of bone should be removed, conserving as 

 much as possible, and a protective dressing applied to the 

 parts. 



Fracture of the Inferior Maxilla. Fracture of this bone 

 occurs very often in dogs and cats. The points of fracture 

 are usually at the symphysis, in front of the premolars, or 

 posterior to the molars. Frequently the fracture is bilateral, 

 but in most cases involves one side. 

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