trauma 2

Question 1

comminuted fracture

Answer 1

multiple fragmented segmets

Question 2

symphysis

Answer 2

area between the mental foramina

Question 3

parasymphysis

Answer 3

posterior to canine, anterior to mental foramen

Question 4

body

Answer 4

between mental foramen and distal of second molar

Question 5

angle

Answer 5

distal of second molar and inferior aspect of ramus

Question 6

ramus

Answer 6

between sigmoid notch and angle

Question 7

condyle

Answer 7

between sigmoid notch and top of condylar head

Question 8

non-favorable fracture

Answer 8

muscle pull displaces the fracture

Question 9

higher risk of infection in ___ fractures

Answer 9

open

Question 10

le fort I

Answer 10

maxilla only

Question 11

le fort II

Answer 11

maxilla + orbits

Question 12

le fort III

Answer 12

entire mid face

Question 13

frontal sinus fracture

Answer 13

brain trauma! rarely seen but in ICU

complications: infection/brain abscess due to lack of latency of sinus

Question 14

most common fracture of midface

Answer 14

nano-orbital-ethmoid

Question 15

what to check for with an orbit fracture

Answer 15

diplopia (eye can fall to different level if floor is disrupted)

Question 16

pan facial fractures

Answer 16

all three thirds of face (upper, middle, lower)

Question 17

goals of tx for facial fractures

Answer 17

fracture healing
return of normal function
restore esthetics
restore occlusion

Question 18

4 principles of management of facial fractures

Answer 18

reduction
stabilization
immobilization
prevent infection

Question 19

malunion

Answer 19

bones dont reduce properly

Question 20

non union

Answer 20

not healing properly

Question 21

tx options for facial fx

Answer 21

no tx
closed reduction
open reduction with rigid internal fixation

combo

Question 22

when would non-sx treatment be appropriate

Answer 22

no malocclusion
compliant patient

subcondylar, green stick

Question 23

what is non sx treatment

Answer 23

soft, no chew diet

close f/u

Question 24

is there high or low tolerance for switching from non surgical to surgical tx

Answer 24

low tolerance

Question 25

what must you have for closed reduction (using dentition as handle to reduce fracture)

Answer 25

good teeth
favorable fracture
mild-moderate displacement

Question 26

two different ways to do MMF

Answer 26

arch bars + IMF

ivy loops + IMF

Question 27

how long do you usually put ppl in MMF

Answer 27

4-8 wks depending on age, med hx

Question 28

MMF for kids, how long

Answer 28

4 weeks

Question 29

how long in MMF for immunocompromised, not healing great pt

Answer 29

6 weeks

Question 30

how long in MMF for non compliant pts

Answer 30

8 weeks

Question 31

contraindications to MMF

Answer 31

severe lung disease

epilepsy

Question 32

define: open reduction with internal fixation (ORIF)

Answer 32

expose fractures for direct visualization and then put back together with screws or plates

Question 33

indications for ORIF

Answer 33

grossly displaced
can’t tolerate MMF
need a short/absent period of MMF

Question 34

MMF for condylar fractures?

Answer 34

no–you can create ankylosis of the condyle to glenoid fossa

Question 35

advantages to intra oral ORIF

Answer 35

no external scar

no facial n damage

Question 36

disadvantages to intra oral ORIF

Answer 36

oral contamination

difficult to reduce fx

Question 37

advantages to extraoral ORIF

Answer 37

excellent access for reduction and fixation

Question 38

disadvantages to extraoral ORIF

Answer 38

external scar

damage to facial n

Question 39

ORIF healing type

Answer 39

primary intention

no bone callous formed, no collagen matrix type thing

Question 40

non rigid, no plates healing type

Answer 40

secondary intention

clot/collagen callous between bones before real bone laid down