Maxillofacial Trauma Flashcards
Problems in the Airways
• Swelling
• Hemorrhage
• Fracture
Problems in Shock
• Hypovolemia
• Pain
Other Probkems in Maxillofacial Trauma
• Consciousness
• Cervical Vertebral Injuries
Priorities Maxillofacial Trauma
• Circulation/hemorrhage
• Airway
• Shock
• Associated injuries which may be life-threatening
• Local injuries
• Triage of facial injuries
Causes of Airway problems
• Tongue falls back
• Dentures, blood clots, aspiration
• Direct laryngeal trauma
• Multiple facial fractures
• The central face has many fragile bones that could easily
be crushed when subjected to strong forces.
• They are surrounded by thicker bones of this system lending it some strength and stability.
Facial Buttresses
2 Components of Buttress System
- Vertical
- Horizontal
Bones of the Maxillofacial
- Nasal
- Lacrimal
- Inferior nasal concha
- Maxilla
- Mandible =1
- Sphenoid =1
- Palatine
- Ethmoid =1
- Zygomatic
- Vomer =1
Vertical buttresses consists
- Nasomaxillary
- Zygomaticomaxillary
- Pterygomaxillary
- Vetical mandible
Horizontal buttresses consists
- Fontral bar
- Infraorbital rim & nasal bones
- Hard palate & maxillary alveolus
- Resist occlusal load
- Interconnect and provide support for above question
- Vertical Buttresses
- Horizontal buttresses
Most frequent traumatized bone
• Related to septal fracture
• Signs:
- Septal deviation/deformity
- Epistaxis
- Nasal obstruction
- Crepitation
• Management:
- X-ray and Closed reduction
Nasal bone
- 2nd to nasal bone
- Parts:
• Symphysis
• Parasymphysis
• Body
• Angle
• Ramus
• Coronoid
• Condyle
• Alveolus
Mandible
Protrusor muscles of the Mandible
Lateral pterygoid
Elevator mmuscles of the Mandible
- Temporalis
- Masseter
- Median pterygoid
- Lateral pterygoid
Depressor- retractor muscles of the Mandible
- Digastric
-Geniohyoid - Genioglossus
- Mylohyoid
Types of fracture
- Muscle forces tend to keep fragments together
- Pull fragments apart
- Favorable
- Unfavorable
Signs and symptoms
• Trismus
• Asymmetry
• Malocclusion
• Step-down deformity
• Paresthesia
• Sublingual hematoma
• Pain and tenderness
• Tooth loosening
Mandible
Mandible
Diagnostics:
• Towne’s view X-ray
• Panoramic X-ray
Mandible
Management:
Goals:
Management:
• Closed reduction
• Open reduction and Internal fixation
Goals:
• Restore occlusion
• Immobilize the mandible
• Maintain nutrition
• Avoid infection
Maxillary fracture
Classifications
• LeFort I/Guerin fracture
• LeFort II/Pyramidal fracture
• LeFort III/Craniofacial dysjunction
- are fractures of the mid face
- they collectively involve separation of all or a portion of the mid face from the skull base
- the pterygoid plate of the sphenoid bone needs to be involved as they connect to the mid face to the sphenoid bone dorsally
Le Fort Fractures (LFF)
RADIOGRAPHIC FEATURES
- orbital line traces the inner margins of the lateral, inferior, medial orbital walls, and the nasal arch
- zygomatic line traces the superior margin of the zygomatic arch of the bbody, extening along the frontal process of the zygoma to the zygomaticofrontal suture
- maxillary line traces the inferior margin of the zygomatic arch, body, and buttress, and the materal wall of th emaxillary sinus. Lines 2+3 form “Dolan’s elephant”
Le Fort Fractures (LFF)
- Hrizontal maxillary fracture, separating the teeth from the upper face
- fracture line passes through the alveolar ridge, lateral nose and inferior wall of the maxillary sinus
Le Fort Type I (FLoating Palate)
