FRACTURES OF BONES OF THE FACE. 341 



The gravity of fractures of the malar bone depends on their 

 position. When involving the orbital process, they resemble those 

 of the orbital process of the frontal bone and the zygomatic process 

 of the temporal bone. When affecting other portions, they may 

 open the superior maxillary sinus, or loosen the attachment of the 

 masseter muscle, causing difficulty in feeding, while the fragments 

 may become separated, and muscular contraction prevent their 

 being replaced in position. 



Treatment of subcutaneous fractures only requires restriction to 

 soft food. Removal of loosened teeth, which may easily convert a 

 simple fracture into a comminuted one, should be deferred. When 

 the gum remains attached, and the root is not exposed, loose teeth 

 again become firm. Fractures of the superior maxilla, complicated 

 with cutaneous wounds, must be treated by antiseptic methods. 

 If pus formation has commenced, strict cleanliness must be enforced, 

 and loose splinters of bone removed. Complicated fractures, involving 

 wounds of the gum, require similar precautions. Even with abun- 

 dance of soft food, animals rapidly lose condition, and economical 

 considerations often suggest that cattle be killed rather than treated. 

 In a thoroughbred mare Moller saw transverse fracture of the superior 

 maxilla nearly above the roots of the incisors. The fracture was 

 caused by falling on the mouth, and all the incisors were displaced 

 downwards and backwards towards the tongue. As the fracture 

 had already existed for several days, replacement could not be 

 immediately effected, but was at length attained by the attendant, 

 according to instructions, daily exercising pressure on the dislocated 

 teeth. Being gradually brought into normal contact with the lower 

 incisors, the act of mastication helped to maintain them in position, 

 and complete recovery resulted. When involving both sides, fracture 

 of the premaxilla may result in the incisors and the bone being 

 displaced backwards or in the bone being split and the frag- 

 ments displaced laterally. In the former case a stout baton of wood 

 can be inserted into the mouth and used as a lever to replace the 

 bone and teeth, which then usually remain in position on account 

 of the opposing row of teeth supporting them ; in the latter case 

 a shallow groove is formed in the corner incisor of each side and a 

 thick silver wire passed several times around the six incisor teeth, 

 supporting them and holding the two bones together. Compound 

 fractures heal most rapidly under antiseptic treatment. Should 

 purulent alveolar periostitis supervene, the affected teeth must be 

 removed. In endeavouring to replace the fragments dislocated by 

 the pull of the muscles of mastication, it has been recommended 



