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MAD-DOG'S MASHED MUZZLE MISERY
DR VITS' GUIDE TO FACIAL BONES 31-3-06
Austria's answer to "have you got anyone with a bad haircut and a short temper (apart from the obvious one)" had a clash of heads in Basel which led to his face getting mushed up.
Details are a bit sketchy at the time of writing, not only for me but for Manu, given how much his eyes are probably swollen right now, but apparently he's bust his nose and his cheekbone and/or maxilla.
So let's start with the maxilla. What the hell is one of them and do I have one or is it just Austrians?
Well, it's the bone that makes the top half of your jaw, your palate and your top lip and the start of both your cheekbones. Not to be confused with the axilla, which is just posh for armpit, but with some lasses I know the two are quite similar in that they stink, are covered in unsightly hair and are great for making farty noises.
The maxilla is sometimes referred to as the anchor of the face. Again in analogy form we're back to Manchester lasses in a stinking of fish, unpleasantly moist and the source of rest for a lot of seamen. This is because it is the central bone of the face and holds everything together, and is as I said the top half of the jaw, the bottom half being the mandible. Fractures of this bone are best treated at the Stoke Mandible hospital.
Most of the understanding of facial fractures comes from the work of Rene Le Fort in 1901, when he spent lots of time hitting dead people very hard in the face then peeling off the skin to see what damage he'd done. And you lot suggest I'm warped. This was probably because he was French, and lacked any live subjects due to the Gallic "Not ze face, not ze face, ha I ave stabbed yeu" approach to fisticuffs.
What he discovered was that if you belt the fizzog hard enough the bones break. Fuck, I wish I worked back then- I'd have loads of Nobel prizes and that. More importantly he realised that if you break it badly enough the bottom half of your face can move around independently from the rest of your skull. This is what doctors call a Le Fort grade III fracture. Actually doctors call it a fucked face, it's just those jumped up dentists - the maxillo-facial surgeons - give it a proper name so they can pretend they are proper doctors and not just glorified tooth-pullers.
Anyway whatever you call it it's not a lot of laughs, and even if it were you can't laugh cos that hurts like salt and vinegar crisps after having your tonsils out. The main problem is that injuries to the face bleed, lots, as anyone who has been bitten on the chin by a whore will tell you. With most broken bones, it's not the break that hurts as much as the raw ends of the bone rubbing against each other that make you wince, that's why we stick stuff in plaster to reduce movement. Unfortunately in the face, you get a load of blood into an enclosed space and the resulting pressure is enough to make one fuck a football pitch in pain.
These type of fractures are diagnosed by quite a subtle clinical technique. The doctor pops a finger into the top of the patient's mouth and then says this might hurt a little, after which he pulls the mandible forwards to see if it moves. If the patient then collapses to the floor sobbing in pain it's probably broken. In some ways an x-ray seems kinder. One can also ask about mal-occlusion; because everything seems a lot larger when felt in the mouth, a fact I thank God for on a daily basis. If your teeth are even a fraction of a millimetre out of whack it just doesn't feel right. This is a far more sensitive (in both senses of the word) way of finding a broken face.
Broken noses - again we may be getting back to Manc lasses - are a lot more satisfying to the Accident and Emergency doctor. With a broken nose a patient goes to casualty, sits for three hours or so to then be told that we don't x-ray noses for breaks and we won't do anything about it for at least a week. This is not because A&E doctors are cunts. That is just a happy coincidence.
It is more due to the fact that it is not whether a nose is broken that is important, it's whether it's bent out of shape that matters. If it is broken then it has probably swollen up 'til it's Gareth sized, and the swelling makes it tricky to see just how bent it is. So we generally leave it for a week or so and get someone else to have a look at it.
So what you're best doing is popping to Tesco for some painkillers, and get the cheap ones don't be fooled by that Advil shite it's the same as the 36p stuff only with a shiny coating. Then have a look in the mirror in a week and if you look like a young Stephen Fry nip to your GP, if the lazy sod's in, and he can send you off to get fixed.
If you're not bothered, it looks alright or you don't want to put your life in the hands of an anaesthetist, just carry on with your life and hey presto you've saved four hours of time that could be better spent on masturbation as this is frowned upon in waiting rooms. Although I once had to treat a guy who was off his tits and was wanking in time to the Lord's Prayer. Oy, you're not coming in my kingdom sunshine.
Which leaves us with cheekbones. Less interesting to us Boro lads of sturdy stock who haven't seen our own since we could get served in pubs but nonetheless now I've seen pictures of what is probably Pogo's main problem. This again is sore mainly due to bleeding, however the real worry is the position of the cheekbone afterwards if it's depressed, that is pushed in rather than moody and sitting around in it's pants smoking fags and watching programmes on chavs moving to Malaga.
Then the fragment of bone has to be pushed back into place to prevent your face looking like a Benwell Cortina for the rest of your life. Facial panel bashing was first performed by Dupuytren in 1751, another Frog and a Baron to boot, but as he invented a disease suffered by Thatcher he can't be all bad.
Depending how bad his injuries are Pogatetz is looking at a number of options. If stuff isn't displaced he has a few ice-packs and then several weeks on the piss to look forward to, as long as he controls his temper. Angry faces are gonna nip a bit for a month or so. He he may end up going for surgery to put all his bits back into place, which will lead to a bit more bleeding and a fair bit more pain.
There is also potential from injury or surgery to damage the nerve supply and this will leave him with a numb cheek, possibly forever. The plus point from this is that stalkers can lick his face without him ever noticing.
Dr Vits is a proper doctor and knows what the dangly bit at the back of your throat is called.
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