OMFS Trauma Flashcards
What are the principles for assessing the trauma case?
Airway
Breathing
Circulation
Disability
What the presenting features of a mandible fracture?
Sublingual heamatoma
2 point mobility vertically
Abnormal sensation/ numbness contra lateral to side of injury
Pain contra lateral
What is the treatment for mandibular fracture (as GDP)?
Tell pt to fast anf grove analgesia
Antibiotics given for open fractures (through dentate mandible or mucosal breach)
Liquid diet
Immediate discussion with OMFS team (urgent referral)
What are some presenting features of a mid face trauma?
Le fort fractures- top jaw is mobile in all
Epistaxis without blow to the nose
V2 numbness without direct blow to nerve
Subconjunctival bleed
Midface mobility
Malocclusion
Surgical emphysema around eye
What is the management for zygomatic fracture as gdp?
No indication for routine antibiotics
Call OMFS - follow up in 7-10 days
No nose blowing
Soft diet (for their comfort)
Warn pt of retrobulbar bleed risk (can go blind)
What is Le fort?
Describes the way in which mid face breaks (transverse fractures in 3 distinct patterns). All fractures in this class extend in to pterygoid columns and plates.
Le fort 1 - palatal fracture (only top jaw moves)
Le fort 2 - teeth and nose come forward
Le fort 3 - teeth and nose come forward, rest of face stays in same place.
What is the management of an orbit fracture as gdp?
Ensure visual acuity (can they see) and Diplopoda (double vision) are recorded.
Discuss with OMFS team - suitable for outpatient follow up
No nose blowing
No antibiotics
Give warning of retrobulbar bleed
What is the management of maxilla fracture as GDP?
Fast pt
Give antibiotics and advise liquid diet
No nose blowing
Referral to OMFS that day
what is the referral pathway to OMFS?
Page OMFS through contacting QEUH
Give patients CHI, phone number, important MH
Keep patient fasted until discussed with OMFS
Allow OMFS for further communication w patient
What is Diplopia?
Double vision
What is sublingual haematoma?
Bruise under tongue, suggestive of fractured mandible
What are the features of a zygomatic fracture?
Unilateral epistaxis (without nose injury)
Eyebrow sign
Paraesthesia when trauma was distant to the extraosseus infra orbital nerve
Buttress tenderness/ FZ/ IOR/ arch tender
What are the features of a Naso maxillary fracture?
Tender IOR/ pyriform
Buttress intact
Often numb
Unilateral epistaxis without blow to nose
What are the features of Naso orbital fractures?
Retropositioned nose
Buttress not tender
Hyperteloric (eyes drift apart)
Often numb
Epistaxis
What are the primary and secondary surveys in OMFS?
Primary - airway, bleeding
Secondary - sight, bony injury, soft tissue injury
