An improved method of treating depressed fractures of the nasal bones.

  • Mason, Lewis D. (Lewis Duncan), 1843-1927.
Date:
[1880]
Catalogue details

Licence: Public Domain Mark

Credit: An improved method of treating depressed fractures of the nasal bones. 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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    AN IMPROVED METHOD OF Treating Depressed Fractures of the Nasal Bones. The following paper by Dr. Loras D. Mason, was read before the Anatomical and Surgical Society of Brooklyn, December 15th, and published in the Annals of the Society for March, 1880 :— In the osseous structure or framework of the nose the principle of the arch is involved, the sides being formed by the nasal processes of the superior maxilla, the crown or centre by the nasal bones. This is well seen in some of the mammals notably the monkey. Experiments upon the cadaver have shown that any force sufficient to depress or break down the crown of the nasal arch necessaiily involves fracture to a greater or less extent of the nasal processes of the superior maxilla, an exception being in young children, in whom a depression may occur without fracture, by a spreading apart of the nasal processes, and thus a depression of the crown of the arch be produced. We also except those cases alluded to by Hamilton, in which the nasal bones are broken at their external lateral margins, and are crowded back or driven in between the nasal processes, constituting “ a displacement or dislocation rather than a fracture.” The result of experiments upon the cadaver have led me to conclude : I. That in all fractures of nasal bones, with depression of bridge, the nasal processes of the superior maxillse are necessarily involved. II. That both nasal processes are usually fractured, and the line of fracture is nearly on the same plane on either side. The indications for treatment are to reduce the fracture or restore the norma’ contour of the nose, and to retain the fragments in position until union shall have taken place. The majority of surgical authorities agree that reduction is easily effected, and recommend the ordinary grooved steel director as best adapted for this purpose, as it combines with delicacy sufficient strength. Passing the director into the meatus just beneath the depressed fragments, pressure is made forward and upward until we have attained a satisfactory elevation of the depressed bones, aiding our efforts within the nose by external manipulation. In the class of fractures under consideration the great difficulty consists in our inability to retain the fragments in place, the sides as well as the centre of the arch being broken down. We have to deal with extensive comminution, and hence under the usual plans of treatment, although the arch may be temporarily restored.