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BDS4 Oral Surgery > Fractures of the Mandible > Flashcards

Fractures of the Mandible Flashcards

1
Q

What is the cause of mandibular fractures

A
  • Trauma is the main cause for mandibular fracture
  • Trauma can result in temporary loss of consciousness
  • ABC should be considered in all trauma causes
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2
Q

What are signs/symptoms of mandibular fracture

A
  1. pain/swelling/limitation of function
  2. occlusal derangement
  3. numbness of lower lip
  4. loose or mobile teeth
  5. bleeding
  6. anterior open bite
  7. facial asymmetry
  8. deviation of the mandible to the opposite side
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3
Q

What are signs of occlusal derangement

A

o Premature biting
o Quality of interdigitation
o Cant bite properly

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4
Q

What is a characteristic sign of mandibular fracture

A

anterior open bite

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5
Q

How does mandibular fracture result in AOB

A

o Mandible fracture pushing segment when ramus is shortened
o Posterior teeth meet prematurely
o Fracture of ramus that can cause shortening of the height of the ramus - bilateral sub condylar fracture

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6
Q

How are mandibular fractures classified

A
  1. involvement of surrounding tissue
  2. number of fractures
  3. side of fracture
  4. site of fracture
  5. direciton of fracture
  6. specific fractures
  7. displacement of fracture
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7
Q

What is the involvement of the surrounding tissue classified into

A

simple
compound
communited

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8
Q

What is a simple fracture

A

fracture in bone and surrounding tissue intact

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9
Q

What is a compound fracture

A

fracture exposed to outside environment so surrounding soft tissue lost or jeopardised

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10
Q

What is a comminuted fracture

A

bone broken in at least two places

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11
Q

What can the number of fractures be classified into

A
  1. Single
  2. Double
  3. Multiple
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12
Q

What can side of fracture be classified into

A
  1. Unilateral
  2. Bilateral
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13
Q

What can site of fracture by classified into

A
  1. Angle
  2. Subcondylar (below condylar region)
  3. Parasymphyseal (centre)
  4. Body
  5. Ramus
  6. Coronoid
  7. Alveolar process
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14
Q

What can direction of fracture lines be classified into

A
  1. Favourable –> direction of fracture minimises displacement
  2. Unfavourable –> direction of fracture line encourages displacement of the fracture
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15
Q

What can specific fractures be classified into

A
  1. greenstick fractures
  2. pathological fractures
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16
Q

What are green stick fractures due to

A
  • Due to soft bone in children
  • Highly unlikely to completely break
  • Usually bone benidng can cracking
17
Q

What are pathological fractures due to

A
  • Osteoporosis
  • Osteomyelitis
  • Paget’s disease
  • Expanding cystic lesion
18
Q

What can displacement of fracture be classified into

A
  1. Displaced –> surgical intervention required
  2. Undisplaced
19
Q

Why is displacement of fracture important

A

major determinant of surgery

20
Q

What factors can cause the displacement of the fracture

A
  • Direction of fracture line
  • Opposing occlusion
  • Magnitude of force
  • Mechanism of injury
  • Intact soft tissue
  • Other associated fracture
21
Q

What is management of mandibular fractures

A
  1. Clinical examination
  2. Radiographic assessment
  3. Treatment
22
Q

What x-ray views do we want

A

2 radiographs at right angles to each other e.g OPT + PA mandible (usually when CBCT isn’t available), OPT does not show mediolateral displacement, posteroanterior view also needed

23
Q

What other radiographs can be used

A

 Occlusal
 Lateral oblique
 Town’s view
 SMV
 CT

24
Q

What is the tx of mandibular fractures

A
  • pain control
  • treatment
25
Q

When are AB given

A

compound fracture

26
Q

What are the two basic principles of tx for fractures

A

reduction & fixation

27
Q

What is reduction

A

this is when we reduce the displacement to its normal anatomical orientation (doesn’t apply for non-displaced fractures)

28
Q

What is fixation

A

fix this in place, commonly done using plates and screws

29
Q

What is the tx for an undisplaced fracture

A

no tx

30
Q

What is the tx for displaced or mobile fractures

A

fixation

31
Q

What are the two types of reduction + fixation

A

closed reduction and fixation (IMF)
open reduction adn internal fixation (ORIF)

32
Q

How do we reach a subcondylar fracture

A

 Retromandibular approach
 Raisdon approach
 Preauricular approach
 Bi-coronal flap
 Endoscopic reduction and fixation

33
Q

What is an absolute indication for ORIF

A

 Bilateral subcondylar fracture with anterior open bite tendency
 Displaced condylar fracture that interferes with mouth opening
 Displaced fracture in the middle cranial fossa
 Displaced fracture that causes occlusal derangement
 Displaced fracture that causes ramus shortening

34
Q

Classify this fracture

A
  1. compound
  2. single
  3. unilateral
  4. angle
  5. unfavourable
  6. displaced (required surgical intervention)

BDS4 Oral Surgery (15 decks)

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