Exam 2 - Jaw Fracture Repair Flashcards
what are the goals of maxillofacial fracture repair?
- return to normal function
- reduce the fracture
- maintain proper occlusion
- provide nutritional support either by providing softened food or feeding tube
what are the 2 types of fractures we’re thinking about with the mandible?
favorable & unfavorable
what is the difference between a favorable & unfavorable mandibular fracture?
the angle of the fracture determines whether or not it is favorable because the force of the muscles pulling will either compress the fracture or distract it further
which fracture pictured is favorable? why? which one is not? why?
top fracture is favorable - force of the muscles pulling will compress the fracture
bottom is unfavorable - fracture will become further distracted because the way the muscles are pulling
when doing invasive surgical interventions for mandibular fractures, what should you be careful with when placing wires?
avoid hitting the tooth roots
what are some indications for using external fixation for mandibular fractures?
- fractures of the vertical ramus
- bilateral fractures
- highly comminuted fractures
where is a very common anatomic location that we see mandibular fractures at?
right in front of or behind the first molar because it is the weakest part of the bone
what is the main difference between invasive & non-invasive procedures used for approaching mandibular fractures?
invasive - mandibular approach where you’re making flaps & cutting through bone
non-invasive - intra-oral approach, using wires & anchoring to teeth/bone
what would be the best approach for this fracture? why?
intra-oral splint with wires to hold everything together - need to stabilize the hard palate to prevent it from moving
what would be the best approach for this fracture? why?
intra-oral acrylic splint with wiring placed first then the splint then more wiring & cover with splint material
need to get rigid fixation to get the maxilla to heal - splint is placed on top of wire to help stabilize & then more wire on top of that, & then cover with more acrylic
if you know that blood supply to the 1st molar is lost, why should you not extract it during your fracture repair?
you need the tooth to serve as an anchor point for intra-oral wiring!!!
can remove once the jaw is healed
if you have a pathologic fracture seen on rads, what is your best approach?
remove the tooth & pack it with consil
keep animal in a muzzle for the amount of time it takes the jaw to heal
what is the number 1 & 2 most common interdigital wiring techniques used by Dr. Dodd?
stout’s multiple loop & risdon’s wiring (risdon’s used for bilateral fracture repair)
what are the advantages & disadvantages of ivy loop wiring for fracture repairs?
advantages - easy to perform
disadvantages - not many fractures are amenable to this kind of fixation
what is essig’s wiring technique?
more complicated technique that utilizes a primary & secondary wire
what wiring technique is shown in this fracture repair radiograph?
stout’s multiple loop wiring technique - same technique as essig’s but only using 1 wire
how is an acrylic splint placed in the mouth for a fracture repair?
intra-oral wiring is used (incorporating the 1st molar as an anchor point) & then put the acrylic on & give it 5 minutes to harden
smooth it over to get rid of any rough edges on the buccal & lingual surfaces
what group of dogs commonly get risdon’s wiring technique due to bilateral fractures?
brachycephalic dogs get these - especially boxers
why can’t you do intra-oral wiring to teeth here?
there is no tooth for you to anchor to - anchor to the bone instead
when may you use this technique for a fracture repair?
when stabilizing caudal mandibular fractures that are not displaced & stabilization is all you need - does the same thing as a muzzle for animals who won’t tolerate it well!
T/F: when doing a jaw fracture repair on an animal that was in a dog fight, you need to make sure you remove all debris/bony pieces or you will get a sequestrum
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