Facial trauma

Question 1

What is a tripod fracture?

Is it common?

Does it require surgery?

Answer 1

• Tripod #’s are the second most common mid-face #s (behind nasal bone #s).
• They are a complex of fractures through 3 structures:
  
  • Zygomatic arch
  • Lateral orbital wall - Fronto-zygomatic
  • Maxilla - inferior orbital rim
• The unstable segment can sink inferiorly -> poor aesthetic outcome - w/out surgery

Question 2

What is a blow-out fracture of the orbit?

What complication can it result in?

Answer 2

• Isolated inferior orbital wall #
• Can result in entrapment of inferior rectus -> inability to elevate the eye -> diplopia on upward gaze

Question 3

What is the system of classification for dental fractures?

Answer 3

The Ellis Classification System

• Ellis I
  
  • Enamal only - non-sensitive
  • Pulpal necrosis rare
• Ellis II
  
  • Through enamel + dentin - ivory-yellow dentin visible
  • tender to palpation
  • ~5% risk of pulpal necrosis
• Ellis III
  
  • Through enamel, dentin and pulp - yellow dentin with pink/red central pulp visible
  • Exquisitely tender
  • Can inject local direct into pulp