Mand Fractures

Question 1

What are the top 2 reasons for mand fractures?

Answer 1

Car wreck and Assaults

Question 2

What are the 3 factors that must be evaluated quickly for someone suffering a major trauma?

Answer 2

1. Neurologic function
2. Airway
3. Bleeding

Question 3

What are the 3 most common areas for mand fracture?

Answer 3

Condylar neck
area of canine
Lower wisdom teeth

Question 4

Incomplete fracture, periosteum intact (typical in children)

Answer 4

Greenstick fracture

Question 5

Involving multiple
fragments of bone which
are independently
dislocated

Answer 5

Comminuted fracture

Question 6

Do not violate
mucosa or skin

Answer 6

Simple fracture

Question 7

Associated with bone
exposure through tissue
avulsions

Answer 7

Compound fracture

Question 8

What are the 4 most common sites for mandibular fracture?

Answer 8

1. Condyle
2. Mandibular angle
3. Symphysis and Parasymphysis
4. Mandibular body

Question 9

What muscle protrudes mand?

Answer 9

Lateral pterygoid

Question 10

What muscles elevate mand?

Answer 10

Masseter
Temporalis
Medial Pterygoid
Lateral pterygoid

Question 11

What muscles depress or retracts mand?

Answer 11

Digastric
Genioglossus
Geniohyoid
Mylohyoid

Question 12

What muscles inwardly displace the mand?

Answer 12

Lateral pterygoid
Medial pterygoid

Question 13

What is the treatment for a favorable fracture in mand?

Answer 13

(IMF)Inter Maxillary fixation (4-6 wks)

Question 14

What is the treatment for an unfavorable fracture?

Answer 14

ORIF (open reduction internal fixation): fix the fracture segments with a plate to prevent separation

Question 15

_______ is suggestive of bilateral condylar fractures

Answer 15

Anterior open bite

Question 16

______ is common with anterior alveolar process or
parasymphyseal fractures

Answer 16

Posterior open bite

Question 17

________ are associated with open bite on
opposite side and deviation of chin towards the side of the fx during
mouth opening.

Answer 17

Unilateral condylar neck fx’s

Question 18

If there is a unilateral condyle fracture, what side does the chin deviate to?

Answer 18

Side of fracture

Question 19

What is the most common dimension of displacement of the condylar neck upon fracture? WHat muscle causes this?

Answer 19

Anteromedial : lateral pterygoid

Question 20

• Involves several stages of healing:
  
  • Hematoma/inflammation
  • Soft callus
  • Hard callus
  • Remodeling.
• This method of bone healing closely resembles endochondral ossification.

Answer 20

Secondary healing

Question 21

• Involves a direct attempt by the cortex to re-establish itself after
  interruption without the formation of a fracture callus. (Open
  reduction and Internal Fixation – ORIF) )
• only works when the fracture edges are touching
  exactly.
• This principle is used for rigid surgical fixation as in ORIF or in
  “green-stick” fractures.

Answer 21

Primary healing

Question 22

How long is IMF used?

Answer 22

6 weeks

Question 23

FOr a case needing ORIF, would you do IMF or ORIF first?

Answer 23

IMF then ORIF

Question 24

The most feared complication of a pediatric mandible fx is
_____ with impact on jaw growth that causes
severe facial deformity- prevent with weekly mobilization

Answer 24

ankylosing of the TMJ

Question 25

What is the most common cause of delayed healing or nonunion of fracture sites?

Answer 25

INfection

Question 26

What is the second most common cause of delayed healing or nonunion of fracture sites?

Answer 26

Noncompliance