Mand Fractures Flashcards
What are the top 2 reasons for mand fractures?
Car wreck and Assaults
What are the 3 factors that must be evaluated quickly for someone suffering a major trauma?
- Neurologic function
- Airway
- Bleeding
What are the 3 most common areas for mand fracture?
Condylar neck
area of canine
Lower wisdom teeth
Incomplete fracture, periosteum intact (typical in children)
Greenstick fracture
Involving multiple
fragments of bone which
are independently
dislocated
Comminuted fracture
Do not violate
mucosa or skin
Simple fracture
Associated with bone
exposure through tissue
avulsions
Compound fracture
What are the 4 most common sites for mandibular fracture?
- Condyle
- Mandibular angle
- Symphysis and Parasymphysis
- Mandibular body
What muscle protrudes mand?
Lateral pterygoid
What muscles elevate mand?
Masseter
Temporalis
Medial Pterygoid
Lateral pterygoid
What muscles depress or retracts mand?
Digastric
Genioglossus
Geniohyoid
Mylohyoid
What muscles inwardly displace the mand?
Lateral pterygoid
Medial pterygoid
What is the treatment for a favorable fracture in mand?
(IMF)Inter Maxillary fixation (4-6 wks)
What is the treatment for an unfavorable fracture?
ORIF (open reduction internal fixation): fix the fracture segments with a plate to prevent separation
_______ is suggestive of bilateral condylar fractures
Anterior open bite
______ is common with anterior alveolar process or
parasymphyseal fractures
Posterior open bite
________ are associated with open bite on
opposite side and deviation of chin towards the side of the fx during
mouth opening.
Unilateral condylar neck fx’s
If there is a unilateral condyle fracture, what side does the chin deviate to?
Side of fracture
What is the most common dimension of displacement of the condylar neck upon fracture? WHat muscle causes this?
Anteromedial : lateral pterygoid
- Involves several stages of healing:
- Hematoma/inflammation
- Soft callus
- Hard callus
- Remodeling.
- This method of bone healing closely resembles endochondral ossification.
Secondary healing
- Involves a direct attempt by the cortex to re-establish itself after
interruption without the formation of a fracture callus. (Open
reduction and Internal Fixation – ORIF) ) - only works when the fracture edges are touching
exactly. - This principle is used for rigid surgical fixation as in ORIF or in
“green-stick” fractures.
Primary healing
How long is IMF used?
6 weeks
FOr a case needing ORIF, would you do IMF or ORIF first?
IMF then ORIF
The most feared complication of a pediatric mandible fx is
_____ with impact on jaw growth that causes
severe facial deformity- prevent with weekly mobilization
ankylosing of the TMJ
