Mandibular Fractures Flashcards

1
Q

type of fracture

A

simple
compound
comminuted
greeenstick
pathological

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2
Q

muscles attached to the mandible

A

temporalis
masseter
lateral pterygoid
medial pterygoid

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3
Q

when is a bucket handle fracture seen

A

seen in edentulous mandibles
bilateral parasymphaseal fractures

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4
Q

extra-oral clinical features

A

pain
swelling
bruising
trismus
cut lip
otorrhoea
anaesthesia/paraesthesia of lip

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5
Q

intra-oral clinical features

A

haematoma (FOM)
malocclusion
step deformity
gingival laceration
mobility or loss of teeth

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6
Q

radiographic views to be taken

A

DPT and PA mandible to allow 3D visualisation

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7
Q

what does a delayed presentation cause

A

increased risk of complications - wound dehiscence, infection, exposure of hardware, non union or fibrous union

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8
Q

who to refer to

A

maxillofacial surgery

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9
Q

what is an open technique

A

fracture margins are visualised intra-orally or extra-orally via an incision

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10
Q

why is the open technique preferred

A

fracture is immobilised to allow a period of healing

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11
Q

what is the closed technique

A

fracture margins are not directly visualised

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12
Q

example of closed technique

A

inter maxillary fixation (wiring the jaws together)

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13
Q

why is closed technique generally not used

A

there is often mobility at the fracture site that can have a detrimental effect on healing

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14
Q

what does the reduction technique do

A

aligns the bone ends anatomically

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15
Q

what does fixation technique do

A

prevents movement of the bone margins whilst healing occurs

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16
Q

methods of open fixation

A

mini plates
reconstruction plates
compression plates
lag screws

17
Q

closed methods of fixation

A

interamaxillary fixation

18
Q

indications for closed technique

A

non-displaced favourable fractures
grossly comminuted fractures
significant loss of overlying soft tissue
edentulous mandibular fracures
fracture in children
coranoid process fractures
undisplayed condylar fractures

19
Q

advantages of closed reduction

A

inexpensive
simple proceudre
no foreign body so reduced risk of infection

20
Q

disadvantages of closed reduction

A

not absolutely stable
prolonged period of IMF up to 6 weeks
possible tmp sequele
decreased oral intake

21
Q

indications for open reduction

A

displaced unfavourable fractures
multiple fractures
edentulous displaced fractures
bilateral displaced condylar fractures

22
Q

advantages of open reduction

A

improved alignment and occlusion
fracture immobilised
avoid IMF
low rate of non-union
lower rate of infection

23
Q

disadvantages of open reduction

A

morbidity of surgical procedure
expensive hardware
need for GA

24
Q

what are Champy’s principles

A

placement of plate along the ideal line of osteosynthesis, counteraction distraction forces that occur along the fracture line

25
why doe edentulous fractures have poor wound healing capacity
poorly vascularised
26
complications of tx
non-union altered occlusion distracted TMJ scars infection necrosis numb lip exposed plate
27
types of condylar fractures
extra-capsular intra-capsular
28
for condylar fractures where does the pt deviate to
the side of the fracture
29
treatment fractured condyle
conservative - soft diet -analgesics action - open reduction and plating -closed - Leonard buttons and elastic traction
30
most common paediatric fracture
condylar most common conservative management with splints