60. Injuries in the MFA ʹ General, Classification Flashcards
Classifications of soft tissue wounds according to their exposure to the outer environment
Open and closed wounds
Open soft tissue wounds according to their exposure to the outer environment
- Incision=> smooth, well-fitting wound margins
- Laceration=> torn wound margins
- Abrasion=>superficial wounds
- Puncture=> just enter the body
- Penetration=> enter and leave the body
- Gunshot=> small entrancen and large exit wound w/ lacerated margins,
- Burns along wound, and surrounded by necrotic area
Closed wounds according to their exposure to the outer environment
- Contusion=>bruise caused by blunt force trauma
- Hematoma=> Localized collection of blood outside blood vessels
- Crush injury=>object compresses a part of the body
How soft tissue wounds classified based on the risk of sepsis
- Clean wound=> No viscus is entered
- No septic area, and no break in aseptic technique
- Clean contaminated wound=>Surgery enters non-infected area=>
- May encounter bacteria
- Contaminated wound=> gross spillage of organisms,
- Infection without pus formation=>
- Sepsis frequently occurs
- Dirty wound=> operation through infected area=>
- Been exposed for over 4 hours
Different types of fractures classified under the midface
- Le Fort I
- Le Fort II
- Le Fort III
Le fort I
- A horizontal fracture=>
- Separates the teeth from the upper face
- Fracture line passes through the alveolar ridge, lateral nose, and inferior wall of the maxillary sinus
Le fort II
- Pyramidal fracture w/ teeth at base and nasofrontal suture at apex
- Fracture line passes through posterior alveolar ridge, lateral walls of the maxillary sinuses, inferior orbital rim, and nasal bones
Le fort III
- Transverse fracture=>
- Separates face from skull base
- Fracture line passes through nasofrontal suture, maxillo-frontal suture, orbital wall, and zygomatic arch
Classification of mandibular fractures
- Based on location of fracture on mandible
- Fractures of the mandibular body=>
*** Median fractures - Paramedian fractures
- Mandibular angle fractures
- Fractures of the ramus
- Condylar neck fractures
- Intra-capsular fractures**
Median fractures
Occur at midline of mandible
Paramedian fractures
Occur adjacent to midline
Mandibular angle fractures
Occur at the angle of the mandible
Fractures of the ramus
Occur in the vertical part of the mandible
Condylar neck fractures
- Occur at neck of condyle=>
- Rounded projection of mandible
Different parts of the neurocranium and skull base that can be fractured
- **Fractures of neurocranium
- Fronto-basal fractures**=>
- Anterior wall of the frontal sinus
- Posterior wall of the frontal sinus
- Orbital roof
*** Fractures of base of skull
**
General classifications of fractures
- Simple fracture=>single fracture line that does not break skin
- Multiple fractures=>More than one fracture line, possibly involving multiple bones
- Comminuted fracture=>bone broken into several pieces
Injuries to hard dental tissues and pulp
- Crown infraction
- Uncomplicated crown fracture
- Complicated crown fracture
- Uncomplicated crown-root fracture
- Complicated crown root fracture
- Root fracture
Crown infraction
Incomplete fracture of enamel without loss of tooth substance
Uncomplicated crown fracture
Fracture with loss of substance
-In enamel or enamel and dentine without pulp exposure
Complicated crown fracture
Loss of enamel and dentine with pulp exposure
Uncomplicated crown-root fracture
Fracture of enamel, dentin and root without pulp exposure
Complicated crown root fracture
Fracture of enamel, dentin and root with pulp exposure
Root fracture
- Horizontal fracture involving dentin, cementum and pulp
- Within Alveolus
Injuries to periodontal tissues
- Concussion
- Subluxation
- Extrusive luxation
- Lateral luxation
- Intrusive luxation
- Avulsion
Concussion
- Injury without loosening/displacement of tooth
- No increased mobility
- Tender to touch
Subluxation
- Injury with abnormal loosening but without displacement of tooth
- Tender to touch
Extrusive luxation
- Partial displacement of tooth out of socket
- Elongated appearance and mobile
- Bleeding from sulcus
Intrusive luxation
- Tooth displaced axially into socket
- Crown appears shortened
- Bleeding from gingiva
Avulsion
Displacement of tooth out of socket
Classifications of mandibular fractures based on region
- Symphysis
- Parasymphysis
- Body
- Angle
- Ramus
- Condylar process
- Alveolar
Classification of mandibular fractures based on fracture pattern
- Green stick
- Compound
- Comminuted
- Complex
- Telescopic/impacted
- Pathologic
Green stick fracture
- Fracture through one cortex
- No mobility of segments
- Children
Simple fracture
Doesn’t communicate with external environment-Closed fracture
Compound fracture
- Communicates with external environment→ skin or soft tissue
- Open fracture
Comminuted fracture
Multiple segments of bone due to force of trauma
Telescopic/impacted fracture
One fractured segment driven into another
Complex fracture
Damage to adjacent structure
Pathologic fracture
-Resulting from normal function in area of diseased bone
Classifications of TMJ fractures
- Displaced-condyle within glenoid fossa
- Dislocated- No longer within fossa
- Extracapsular-Fracture not involving capsule of TMJ
- Intracapsular-Fracture within TMJ capsule
Types of soft tissue trauma
Contusion
Abrasion
Laceration
Tissue avulsion
Soft tissue contusion
- Bruise without break in skin/mucosa
- Subcutaneous haemorrhage→ hematoma and swelling of tissue
- May indicate fracture
Soft tissue abrasion
-Superficial wound→ rubbing or scraping of skin or mucosa
Soft tissue laceration
- Penetrating wound into soft tissue
- Disrupts vessels, nerves, muscles and glands
- Common in lips and gingiva
Soft tissue avulsion
- Loss of tissue
- Rare
- Seen in bites
