FEACTUEES. 



231 



looked and may even sometimes escape recognition untH the rep- 

 aratiye process has been weU estabhshed and the discovery of the 

 wound becomes due to the prominence caused by the presence of 

 the provisional caUus which marks its cure. When the fracture is 

 complete it wiU be marked by local deformity, mobihty of the 

 fragments, and crepitation. Nasal hemorrhage, roaring, frequent 

 sneezing, loosening or loss of teeth, difficulty of mastication, and 

 inflammation of the cavities of the sinuses are varying compUca- 

 tions of these accidents. The object of the treatment should be 

 the restoration of the depressed bones as nearly as possible to 

 their normal position, and their retention in place by protecting 

 spUnts, which should cover the entire facial region (Figs, 254, 255), 



Pig. 255.— Apparatus for Fracture of the Bones of tlie Face Applied. 



and special precautions should be observed to prevent the patient 

 from disturbing the dressing by rubbing his head against sur- 

 rounding objects, such as the stall, the manger, the rack, etc. 

 Clots of blood in the nasal passages must be washed out, collec- 

 tions of pus must be removed from the sinuses, and if the teeth 

 are loosened and likely to fall out, they should be removed. If 

 roaring is threatened, tracheotomy is indicated. 



Fractures of the, Pre-Maxillary Hone. — These are mentioned 

 by continental authors. They are usually encountered in connec- 

 tion with fractures of the nasal bone, and may take place either 

 in the width or length of the bone. 



The deformity of the upper Up, which is drawn sideways in 



