60 
FRACTURE OF THE NASAL BONES. 
kicks, 01 powerful blows also produce them. Horses suffering from 
brain disease occasionally fracture the nasal bones by striking the head 
against walls. In other animals the accident is rarer. In dogs it is 
sometimes due to a blow with a stick. The fracture may be single or 
double-sided, longitudinal or transverse, subcutaneous or compound. 
Fiagments of bone may perforate either the skin or mucous membrane, 
and thus produce a compound fracture. 
Diagnosis is not difficult. There is usually deformity of the nose and 
the neighbouring parts, bleeding from the nostrils, and sometimes diffi¬ 
culty in breathing, produced by narrowing of the nostril or accumulation 
of blood. Injuries to the lachrymal duct are indicated by the appear¬ 
ance of blood-stained tears and ecchymoses in the inner canthus of the 
eye. Tearing of the Schneiderian membrane may be followed by 
emphysema about the face. Diagnosis only becomes difficult where 
much swelling exists. 
Prognosis is on the whole not unfavourable. In rare cases death 
results from bleeding or suffocation, or at a later stage from septic 
poisoning, bo long as the fracture is subcutaneous and no great dis¬ 
placement exists, complete recovery may be looked for. In severe 
displacements, and especially where both nostrils are fractured, an 
asthma nasale may remain. Caries of the turbinated bones sometimes 
follows compound fractures. 
Treatment of subcutaneous fractures without much dislocation requires 
nothing more than a few days’ rest. Compound fractures must, as far 
as possible, be antiseptically treated, loose splinters of bone removed, 
and dislocated bones replaced. Where portions of bone have been 
driven inwards, replacement is most difficult. In large animals it may 
be effected by introducing into the nostril a stick, with the rounded end 
wrapped m lint or tow, and therewith pressing the bone forcibly out¬ 
wards, but this only succeeds in the lower part of the nostril. In the 
upper part the upper turbinated bone lies in contact with the nasal bone, 
and may easily be damaged by such manipulation, caries resulting. 
Care must also be taken not to convert a simple into a compound 
fracture. In some cases it is advisable to trephine, and remove pieces 
of bone which have been pushed into the nasal meatus. 
It must not be forgotten that dyspnoea may be produced by general 
swelling of the nasal mucous membrane, and that during the first forty- 
eight hours tracheotomy may become necessary. The owner should be 
warned of this contingency, especially when the practitioner lives at a 
distance. In certain cases it may be advisable at once to perform the 
operation. 
