Trauma

Question 1

Common sites of mandibular fracture

Answer 1

1. Condyle (29.1%)
2. Angle (24.5%)
3. Symphysis & parasymphysis (22%)
4. Body (16%)
5. Alveolar (3.1%)
6. Ramus (1.7%)
7. Coronoid (1.3%)

Question 2

What xrays to take for trauma patient (suspect mand fracture at A&E)

Answer 2

• CT scan gold standard
• Reverse Townes for condylar fracture
  *No DPT at A&E

Question 3

What type of xray to take for condylar fracture

Answer 3

DPT too
Reverse Townes

Question 4

How to manage mandibular fractures

Answer 4

Restore pre-op occlusion –> Reduction –> Fixation –> Soft tissue closure

Question 5

What is reduction in trauma?

Answer 5

to restore bony segments to the proper anatomical location, and to place teeth in proper occlusion

Question 6

Conservative management for mandible fractures

Answer 6

Closed reduction via manual reduction
IMF with arch bars/ screws/ wires/elastics

Question 7

How long to put IMF for? Condyle and tooth bearing region different times

Answer 7

Condyle fracture: 2-3 weeks
Tooth-bearing region fracture: 4-6 weeks

Question 8

Features of unilateral condylar fracture

Answer 8

• Telescoping (shorter) on affected side, with ipsilateral premature contacts on posterior teeth
• Midline deviation to affected side

Question 9

What are features of condylar fracture?

Answer 9

• TMJ region symptoms: preauricular swelling and pain
• Reduced / absent joint mobility
• Limited mouth opening
• Battle sign (ecchymosis behind ear): indicates bleeding from middle ear cavity
• Malocclusion