Fractures of the frontal, nasal and maxillary bones are almost always impression fractures with at least some comminution. Very often more than one of these bones are involved in the injury.
While fractures of the nasal bone are commonly associated with separation of large parts of soft tissue from the bone, soft tissue involvement is less common in fractures of the frontal and maxillary bones.
Example of a fracture of the frontal and nasal bone.
Example maxillary fracture.
Facial skull fractures
Most trauma to the facial region include large impression fractures with multiple large, but also smaller, fragments that are pushed inward by an external force. Like most head fractures in the horse, facial fractures are usually open and frequently large sections of skin are separated from the bone.
As with fractures of other parts of the skull, the extent of involvement of the facial skull is often underestimated without a thorough radiographic or computed tomographic examination. The surgeons are frequently surprised by the actual extent of the traumatic insult depicted by computed tomography and/or encountered during surgery. The prognosis of facial skull fractures, even large ones, is usually very good because of the abundance of vascular supply to the region and the low physical load most bones encounter during mastication.
Fractures of the facial skull must be examined thoroughly for possible involvement of adjacent structures such as the oral and nasal cavities, sinuses, the orbit, eyes and adnexa, as well as the cerebrum and other parts of the nervous system.