Classification of fractures

Question 1

Overview of mandibular fractures

Answer 1

50% of mandibular fractures are multiple

-Condylar
-Angle
-Body
-Symphyseal
-Alveolar
-Ramus
-Coronoid precess

Question 2

4 CLASSIFICATION OF MANDIBULAR FRACTURES

Answer 2

1. Horizontally favorable
2. Horizontally unfavorable
3. Vertically favorable
4. Vertically unfavorable

Question 3

6 CLASSIFICATION OF MIDFACE FRACTURES

Answer 3

1. LeFort I Transverse Maxillary
2. Lefort II Pyramidal
3. Lefort III Craniofacial
4. Dysjunction
5. Zygomatic Complex
6. Naso-orbital/Ethmoid

Question 4

Three buttresses allow face to absorb force

Answer 4

1. Nasomaxillary (medial) buttress
2. Zymaticomaxillary (lateral) buttress
3. Pyterigomaxillary (posterior) buttress

Question 5

BASIC SURGICAL PROCEDURE

Answer 5

1. Place the teeth in the proper occlusion
2. Appropriate reduction of bony fractures
3. Bony repair should also precede soft tissue repair
4. Fractures treated as soon as the pt condition permits
5. Rigid fixation begins in the area where fractures can be most easily stabilized .

Question 6

PRINCIPLES FOR MANDIBULAR FRACTURES

CLOSED REDUCTION

Answer 6

Closed reduction
1. IMF ( Prefabricated arch bar )
2. Ivy loop wiring
3. Continuous loop wiring
4. Heavy elastic traction (pull the bony segments)
5. Circummandibular wiring (edentulous p’t)
6. Lingual or occlusal splint (children)

Question 7

OPEN REDUCTION

Answer 7

Open reduction
Continued displacement of the bony segments
Unfavorable fracture (angle fracture)
Intraosseous wiring + IMF (3 to 8 weeks)
Rigid internal fixation these method use bone plates, bone screws or both to fix the fracture.
Proper occlusal established before reduction stabilization and fixation of the bony segment

Question 8

3 ADVANTAGES OF RIGID FIXATION

Answer 8

1. IMF is eliminated or reduced
2. Improved postoperative nutrition
3. Improved postoperative hygiene

Question 9

PRINCIPLES FOR MIDFACE FRACTURES

Answer 9

1. Zygomaticomaxillary buttress
2. Zygomaticofrontal area
3. Orbital rim area

Question 10

PRINCIPLES FOR MIDFACE FRACTURES

Answer 10

1. Occlusion related (Le fort fractures)
   -occlusion relationship
   -Reduction of bone segment
   -tablization of fractured segments
2. Stablization of fractured segments
   -Direct Intraosseous wiring
   -Suspension wiring technique
   -Bone plate & screws
3. Zygomatic Complex & Naso-orbital
   - Ethmoid fracture
   -Repair functions of eye, nose & mastication.
   -Acceptable esthetic
   -Prevent interfere to coronoid process (Zygomatic arch)