Maxillary Fractures Flashcards
What is the anatomy of the maxilla?
- 2 bones = R & L
- Inferior = alveolus/ hard palate
- Superior = Orbital floor
- Anterior = anterior face
- Posterior = infratemporal fossa
What are the aetiology of maxillary fractures?
- Trauma (blunt, sharp)
- Iatrogenic (intended, unintended)
- Pathological (bisphos related)
What is the management of a maxillary fracture?
ATLS principles
AIRWAYS maintenance and cervical spine protection
- -> if can talk, airway clear
- -> if can’t -> finger sweep/ turn head to side -> head tilt chin lift OR jaw thrust
- -> airway adjuncts may be required
BREATHING and oxygenation
- -> High flow oxygen via rebreather mask
- -> evaluate chest movements
CIRCULATION and haemorrhage control
–> observe = consciousness, skin colour, pulse (60-100), bleeding (pressure to stop)
DISABILITY/ neurological status
–> establish = consciousness (GCS), neruo assessment (AVPU)
EXPOSURE/ environment control
–> undress but keep warm under blankets
What symptoms is commonly seen in maxillary fractures HISTORY?
- Malocclusion
“do you feel your teeth meet normally when bite together?” - Altered sensation
“does it feel different?” - Diplopia
“do you have double vision?” - Change in facial appearance
“once swelling gone, do you think your face looks diff?” - Decreased air entry
- Nose bleeding
What are the signs of retrobulbar haemorrhage? And what is the tx?
- Paralysis
- Pain
- Proptosis (eye pushed forward)
- Bleeding behind eye
- Decreased acuity
Lateral canthotomy (relieves pressure)
What are the causes of bleeding from the ear?
TWO CAUSES
- Base of skull fracture –> perforated ear drum
- Tear in EAM (indicative condylar #)
What investigations are usually carried out for maxillary fractures?
- Plain radiographs
- CT
- Study models
What are the complication of maxillary fractures?
- Malunion
- Nonunion
- Infection
- Haemorrhage
- Persistent hypoaesthesia
- Late enopthalmos
