Midface Fracture Flashcards
What would the symptoms of a mandible fracture be
Sublingual Haematoma
2 point mobility vertically
Abnormal sensation contra lateral to side of injury
Pain contra lateral to side of injury
Numbness that can’t be explained by direct injury to nerve
For a suspected fractured mandible how many X-rays would you take
2 taken at different planes or maybe a Ct scan
What’s the tx for a fracture mandible
Must be fast
Analgesia
Starve the patient
Antibiotics for open fractures through dentate mandible or mucosal breach, amox or met
Liquid diet
Immediate discussion with omfs team
What’s the symptoms for a mid face (eyebrows to top teeth) fracture including the zygoma
Epistaxis without a blow to the nose
V2 numbness without a direct blow to nerve
Subconjunctival bleed (white bit of eye very deep red)
Midface mobility (best test)
Malocclusion
Surgical emphysema around eye
Swelling after nose blowing
Diplopia (double vision)
Csf out of nose/ear (it looks like water)
Where do all le fort fractures extend to
Pterygoid Columns
What is tx for zygoma fracture
No antibiotics
No nose blowing
Soft diet
Give warning about retrobulbar bleeding
Call omfs
What are le fort fractures
transverse fractures of the midface
What are the symptoms of a orbit fracture
Ensure va and diplopia documented
Discuss with omfs
What’s important about zygoma and orbit fractures
All zygoma fractures are orbit fractures but not all orbit fractures involve the zygoma
How to treat a maxilla le fort like fracture
Treat it fast
Antibiotics
Liquid diet
No nose blowing
How do you refer
Contact the QEUH OMFS DCT on call via switchboard at the QUEH, page them don’t get out through to ward
Have pt details ready
Keep pt fasted
Don’t tell the pt a date
What are the signs of a zygoma fracture
Unilateral epistaxis when the nose has not been injured
Eyebrow sign
Paraesthesia when trauma was distant to extraosseous infraorbital nerve
Buttress tenderness/FZ tender/IOR tender/Arch tender when not punched discretely in all these areas
What signs of a orbit injury are also signs of other injuries
Infra-orbital paraesthesia (zygoma)
Diplopia (intracranial injury/nerve palsy)
Subconj bleed (Zygoma)
What imaging should be taken for possible fractures
2 views madatory as a minimum
-OPG and PA mandible
2 angulations of PA for injury involving the zygoma or orbit
What is involved in le fort fracture 1
They are essentially a separation of the hard palate from the upper maxilla due to a transverse fracture running through the maxilla and pterygoid plates at a level just above the floor of the nose
DOES NOT INVOLVE glabella or zygoma
