What does an open jaw fracture look like? What to do with a jaw fracture - the main signs and principles of treatment. Rehabilitation and the consequences of a fracture

Fractures of the jaw in medical practice are quite common. Doctors note that jaw bone injuries account for a seventh of total fractures.

To recognize the problem in time and accept necessary measures, should be dealt with existing types injuries and their symptoms.

What is a jaw fracture

Jaw fractures are damage to the jawbone in any place, accompanied by a violation of the integrity of the surrounding tissues. This can affect the muscles facial nerves, vessels.

The causes of this kind of injury are different, but most often they are caused by mechanical impact: impact, fall, accident. In addition, there is also a pathological fracture, which occurs as a result of external influence on the jawbone if present chronic diseases such as bone syphilis, osteomyelitis, tumors. Yes, at severe course osteomyelitis, areas of the bone die off, which leads to its spontaneous fracture.

How to recognize a broken jaw

There are several signs that can suggest the presence of a jaw fracture:

When injured, a person feels severe pain.
When you try to open or close your mouth pain intensify, a click may be heard.
The jaw may move to the side.
When there is a rupture of the facial tissues above the jawbone.
In the case when the nerve endings are affected, some numbness is felt when touching the face.
Headache, dizziness.

Symptoms can vary, depending on which part of the bone is damaged.

To determine the type of jaw injury, you should immediately consult a doctor and conduct diagnostic analysis. It includes an external examination, X-ray examination.

A jaw fracture is often accompanied by brain damage or cervical spine. To exclude such complications, an additional analysis is carried out.

Types of jaw fractures

Jaw fractures have an extensive classification in several areas:

1. Separation by etiological or causal factor:

the occurrence of a fracture of the jaws as a result of an injury;
fracture of the jaw as a result of tissue and bone pathology.

2. Depending on the fracture line:

longitudinal;
straight;
oblique;
zigzag;
fragmented;
transverse.

3. By the number of debris:

multiple;
single;
double;
triple.

4. Depending on the location of the fracture:

fracture upper jaw.

5. According to the degree of violation of the jawbone:

full;
incomplete (cracks, breaks).

6. Depending on the degree of involvement soft tissue:

closed fractures - soft tissues are not affected;
open - the integrity of soft tissues is broken.

In addition, jaw fractures are:

with defects and without defects;
combined.

Mandibular fracture treatment

The main symptoms of mandibular fractures are:

pain;
inability to chew food due to pain;
possible numbness of the chin, lips;
malocclusion;
nausea;
dizziness.

In the process of diagnosis, the doctor, first of all, determines the general physical state sick. For this, the pulse and pressure are measured. After that, in order to exclude a traumatic brain injury, a tomography is performed.

During an external examination, painful points, defects, hematomas are determined. A test is carried out in which the alleged fracture site is revealed. Then an X-ray examination is performed.

It has a very fine structure in the corners and even with a slight impact or other lateral damage a fracture is possible.

Often there are double, triple and multiple fractures of the lower jaw. The treatment of such injuries is complex and takes more long period rehabilitation.

Therapy

When there is a fracture of the lower jaw, treatment should be followed immediately - this will avoid many complications.

Before transporting a person to medical institution the patient should be given first aid. It is necessary to fix the lower jaw in a stationary state with a bandage or bandage.

The most common sites for mandibular fractures are:

projection of the mental hole;
the middle of the jaw;
articular process;
jaw angles.

Tissue edema often accompanies a mandibular fracture. Treatment in this case begins with the application of a cold compress. After that, under local anesthesia, the doctor performs a procedure to combine bone fragments, and then fixes the jaw for the entire period of treatment.

The lower jaw bone can be fixed with a nylon core or wire. In parallel, anti-inflammatory therapy is carried out, vitamins and means to strengthen the immune system are prescribed.

Fracture of the upper jaw

The upper jaw is a paired bone, it is located in the center of the face and is involved in the formation of the nasal cavity, mouth, eye sockets. A fracture of the upper jaw is very dangerous. First, the skull may be affected. Secondly, there is a danger of a concussion or the development of a disease such as meningitis.

In addition to the standard symptoms, fractures of the upper jaw may be accompanied by hemorrhage, hematomas in the eye area, blurred vision, and loss of consciousness. Respiratory and chewing functions are difficult. If a person cannot breathe, the airways and oral cavity should be freed from interfering foreign bodies.

With such an injury, bleeding may open. To stop it, you should apply a tampon or a pressure bandage.

Complicated jaw fracture

Complicated is a fracture of the jaw with a displacement, in which there is a violation of the normal arrangement of bone fragments. May be complete or incomplete.

Complete fracture - the connections between the components of the bone are broken.

Incomplete - the connection between the components of the bone is not broken or only slightly broken.

A fracture of the lower jaw with a displacement initially requires the alignment of fragments, removal of edema, after which rigid fixation is necessary.

In the event of a fracture, traction is often necessary. For this, a special orthopedic apparatus is used, which gradually returns the damaged bone to the correct position.

Such injuries are very dangerous, because they can provoke asphyxia, which, in case of untimely assistance, can lead to lethal outcome. To prevent suffocation, clean oral cavity from foreign bodies, blood, and then place the person in horizontal position, face down, with a rolled-up blanket or clothing under the chest.

Splinting for a broken jaw

The main method of treatment of jaw fractures is splinting - this is the fixation of fragments using a special design made of wire or plastic.

Splinting is of the following types:

One-sided - used for a fracture of one half of the jawbone. A wire is used that is attached to the injured area.
Bilateral - a more rigid wire is used, hooks and rings are additionally installed.
Double jaw - used for fractures of the upper and lower jaws with displacement. A copper wire is used, which is attached to the teeth and fixes both jaws with rubber rings.

A splint for a fracture of the jaw can also be plastic. It is applied under the chin, runs along the cheeks and is fixed with a bandage around the head. But this method, as a rule, is resorted to if urgent splinting is required (for example, when transporting a patient to a medical facility).

If a person has a complicated fracture of the jaw, splinting is carried out strictly after combining the fragments. Additional external fixators may also be required.

Possible Complications

To possible complications fractures of the upper and lower jaws include:

sinusitis;
osteomyelitis;
improper fusion of fragments;
false joint.

Sinusitis most often occurs with a fracture of the upper jaw and is due to the presence of small bone fragments in the maxillary sinuses.

Osteomyelitis - frequent complication with a fracture of the lower jaw. Represents purulent formation that affects the bone. In order to prevent the development of this pathology, antimicrobials, physiotherapy, taking vitamins.

Jaws may occur in the following cases:

the patient turned to a medical institution late;
the treatment regimen was violated;
when a fracture of the jaw occurred, splinting was carried out according to an incorrectly selected method.

You can fix the situation surgically(most often they do this) or with the help of an exhaust system.

It can occur with osteomyelitis, which is a violation of the jawbone with mobility in some departments. Treatment is only surgical.

Rehabilitation

The recovery period after a jaw fracture includes the following steps:

Fragment fixation. A splint is used for a fracture of the jaw and some other types of fixing devices.
Anti-inflammatory therapy. It includes taking antibiotics, antifungal and restorative drugs.
Proper oral hygiene. It is carried out by both the doctor and the patient himself. It consists in cleaning the splint, teeth from food debris, treating the oral cavity with special antimicrobial agents. Rinsing with a solution of soda should be performed daily, and antiseptics should be used after meals.
Physiotherapy - special gymnastics aimed at restoring the functions of the jaw. Exercises should be started from the first day of the injury in order to prevent scarring and avoid such complications as an improperly healed jaw fracture.

To restore all the functions of the jaw, you should perform gymnastics daily. Its principle is to develop muscles, joints. To do this, you need to make massaging movements, and then proceed to the pronunciation of letters, sounds, opening your mouth wide. You can imitate chewing movements. At first it will cause pain, but gradually the discomfort will pass.

If a child is hurt...

According to statistics, this kind of damage is observed in boys aged 6 to 14 years, i.e., during a period of increased motor activity, then the number of accidents goes down. In girls, there is no similar relationship between the frequency of fractures and age. In any case, this injury is very unpleasant, but the worst thing is that it is mainly accompanied by craniocerebral injuries, violation of the integrity of other bones and soft tissues. Self-employment is strictly not recommended. At the slightest suspicion of a fracture, you should immediately seek qualified help.

When visiting a doctor, a medical history is compiled. It is not always possible to visually diagnose a jaw fracture, so a specialist in without fail appoints x-ray examination. According to its results, a treatment plan is drawn up. The rehabilitation process is not much different from that described above.

Nutrition rules

Due to the fact that during therapy and rehabilitation the jaws are in a fixed position, it is imperative to adjust the diet. The bone fuses within a month (at least), and during this time only liquid food should be consumed.

Jaw fractures involve eating food that is no thicker than sour cream in consistency. Approximate menu may consist of soups with grated vegetables, fruit purees, dairy products, broths, various cereals. After removing the tire, it is necessary to start taking solid food gradually so as not to provoke gastrointestinal disorders.

Breakfast may consist of a glass of kefir, liquid oatmeal, applesauce.

For lunch, you can cook any cereal, chicken or rabbit broth, drink a glass of orange juice.

Can be used as a snack dairy products. For dinner, you should prefer thin potato soup, fruit puree.

One of the varieties traumatic injury jaw apparatus are fractures. Depending on the location of the injury, both a mandibular fracture and a maxillary fracture may occur. A fracture is a violation of the integrity of the bone as a result of third-party mechanical impact.

According to statistics, a fracture of the lower jaw among skeletal injuries in humans is only 7-8% of total number injuries.

When the jaw is fractured, pain occurs and the bite changes

The general classification of fractures is as follows.

Due to the occurrence

Fracture of bones in the jaw region is a consequence of mechanical impact. Due to the occurrence, it is divided into traumatic and pathological. Origin traumatic fractures subdivided into:

household;
sports;
firearms;
received in a different way.

A pathological fracture is diagnosed when, in the case of chronic diseases, strength can be greatly reduced bone tissue. Osteomyelitis and osteoporosis lead to such consequences in chronic form, benign and malignant or cystic formations. Pathological processes lead to the fact that a fracture of the lower jaw can occur both as a result of even an insignificant mechanical effect, and for no apparent reason at all.

Location of the defect

Depending on the location of the fracture in relation to the point of application of the impact, the mandibular fracture is classified as follows:

direct fracture - a bone tissue defect is formed directly at the site of application of an extraneous force;
indirect - bone damage does not appear at the point of application of force, but at a distance from it, in a less strong area;
mixed type - there is a combination of direct and indirect fracture.

By violation of the integrity of soft tissues

Depending on whether there are injuries and ruptures of soft tissues, the injury is divided into:

closed fracture - skin and mucous tissues were not affected;
open - the integrity of soft tissues is broken or under the influence of external factors, or the edge of a broken bone (has a more severe clinic and is always infected).

By the nature of the injury

no offset;
with offset;
comminuted;
linear.

Basic fracture mechanisms

In a fracture, there are four main operating mechanisms:

Inflection.

At the moment of impact, the greatest stress falls on the thin and curved areas of the bone - the angle, canine, mental foramen and condylar process. It is in these places that the integrity of the bone tissue is violated during kinks.

Shift.

When shearing, the acting force is applied from the bottom up to the area of the bone that does not have support. As a result, a longitudinal fracture is formed, the site is displaced relative to the bones that have support.

Compression.

Striking from the bottom up in the area of the angle leads to the fact that the part of the bone fixed in the glenoid cavity breaks under the action of compression.

Separation.

At clenched teeth impact from top to bottom in the chin area can lead to separation of the thin coronoid process from the body of the jaw by the powerful temporal muscle.

By amount of damage

Single.

Of the total number of fractures in this area is 47%, most often located between the 7th and 8th, as well as between the 2nd and 3rd teeth.

Double.

Jaw fractures are most often caused by hard hit or accidents

According to statistics, it occurs in 46% of victims; localized in the areas "canine - condylar process", "canine - angle", "angle - molars". The most characteristic injuries are one fracture on each side.

Triple.

It occurs in 4.8%, the characteristic localization is the region of the right and left condylar processes and either the region of the canine or the region of the central incisors.

Symptoms, diagnosis and treatment

For patients with a fracture of the lower jaw, visually determined asymmetry of the face is characteristic. Its symptoms are a shift of the chin from the midline to the side and the presence of soft tissue edema in places of traumatic bone injury. Most often, victims complain of the following symptoms:

severe pain in the lower jaw, which increases sharply when you try to open and close your mouth, you can only eat semi-liquid food;
teeth do not close;
soft tissue swelling.

If there are symptoms of nausea and dizziness, the victim should be checked for possible concussion brain as a consequence of trauma. This is typical not only in the case when there is a fracture of the upper jaw, but also the lower one. Clinical picture is detected by examination of external injuries and the oral cavity, palpation to identify protrusions and defects in the jaw bone.

There is a whole methodology diagnostic criteria, which help to determine the diagnosis quite fully - with the identification of existing displacements of fragments and the type and direction of damage. Great importance for anamnesis has information received from the victim, about the circumstances under which the injury was received. This will help to timely identify or exclude the possibility of other hidden injuries of the body, determine their symptoms and prescribe treatment correctly.

Treatment of a patient with a fracture of the lower jaw requires an accurate idea of the direction of the fracture with possible displacement of bone fragments. It is necessary to develop an optimal plan resuscitation. Get complete picture consequences of trauma will help following methods research:

x-ray examination, including panoramic radiography;
orthopantomography;
computed tomography in the frontal and sagittal planes.

AT recent times appeared and is widely used method of radiography without the use of film - electroroentgenography. While maintaining the principle of research new method wins in mobility.

Treatment of a jaw injury

There are several methods that allow the treatment of patients with this diagnosis. This takes into account the location, nature and characteristics of the injury. The following methods apply:

conservative treatment - orthopedic methods, are used in 89% of cases as the most effective;
surgical intervention;
methods for restoring reposition by fixing fragments using devices, devices or devices.

Regardless of the method used, the treatment will be more effective the sooner the victim applied for medical care. To reduce pain in the injured and to avoid additional displacement of fragments, the mobility of the injured jaw should be limited in any way possible.

Orthopedic treatment is based on the method when the superimposed tire provides fixation of the jaw at the fracture site. The method was used for the first time at the beginning of the 20th century for the treatment of wounded with maxillofacial injuries in military conditions. Splinting as a method turned out to be so successful that it is still used today. Only the materials from which the tire is made, its modification and application methods change.

The fracture is fixed using the following standard fasteners:

Vasiliev's standard tape bus;
plastic tire Urazalin;
single jaw compression-distraction splint Sagandykov;
fast-hardening plastic tire and others.

Splinting with wire frames is effective method treatment of diseases such as mandibular fracture, but, unfortunately, has its limitations. Splinting involves attaching wire splints to the teeth, and if they are absent or insufficient, the method is not applicable.

Surgical treatment is carried out in cases where it is impossible to use orthopedic methods:

there are not enough teeth to carry out splinting;
the presence of bone defects;
compound fracture of the lower jaw with displacement, not amenable to reposition.

Treatment surgical methods consists of the following techniques:

the imposition of bone sutures using polyamide or nylon threads;
fixation of fragments by means of steel wires or rods (performed intraosseously);
fixation of fragments by means of extra-osseous metal splints or plates;
the use of devices Rudko, Uvarov, Vernadsky and others for bone fixation.

Complication of the treatment process

Treatment of an injury such as a fracture of the lower jaw, especially if it is aggravated by displacement, is always fraught with complications. In the case when the fracture is open, the wound is always infected, which threatens the development of inflammatory and purulent processes. In addition, to possible complications should be attributed to post-traumatic osteomyelitis, the occurrence false joints, inhibition of fracture consolidation.

healing process

Recovery after a fracture takes a long time and cannot be accelerated. It's complicated biological process passing in stages.

With a broken jaw varying degrees gravity, splinting of the jaws is used

As an example, the consequences of even an uncomplicated fracture without significant diastasis between the fragments will begin to smooth out only after about three months, when the formation is completed. callus. And after that, for about six months, the structural reorganization of the callus will take place and bone beams will form. Radiographs show the border of the fracture, sometimes even after a year.

Trauma in pets

In a cat or dog living at home, just like in humans, a fracture of the jaw bones is possible. In this case, you should take care of the treatment and nutrition of the pet in case of a jaw fracture, because the usual diet for the animal will not work. The classification of injury in a cat differs little from that of a human. You should know that for a cat, symphyseal injuries are most characteristic, passing through the mid-sagittal line.

When jaw injuries the cat needs to urgently contact the veterinarian, and also remember that although the appetite for the pet will return quickly, the animal will not be able to eat food that needs to be chewed for a long time. A fracture in a cat heals, even with the most best conditions care for a long time.

Injuries associated with damage to the bones of the jaw can lead to dangerous consequences for a person, so you should be aware of the symptoms and treatment of a jaw fracture, as well as how much it clamps?

Pathology occurs due to a pronounced mechanical effect on the jaw, or due to other pathologies. Distinguish partial lesion bones, complete, with displacement and others. Self-treatment in cases of such injuries.

Causes of a jaw fracture

The main causes are divided into two types: pathological and traumatic.

Pathological, including anomalies of the anatomy of the jaw bones and the consequences of diseases of various etiologies:

hereditary pathologies;
malignant and benign neoplasms;
cysts;
tuberculosis;
treatment with certain drugs;
metabolic disorder;
lack of nutrition, vitamins and minerals;
infections and others.

Traumatic, including the consequences of falls, injuries, blows, injuries, intense loads, road accidents and other conditions. Most injuries are due to:

driving various kinds transport;
active lifestyle and other incidents;
abnormal removal of one or more teeth;
under pronounced physical impact, for example, when applying firearms, jaw injuries can be complicated by splinters.

Symptoms

Pain, intense and pronounced, increasing with jaw movement, chewing, talking. Pain due to injury thin shell bones - periosteum, in which there are many nerve endings. In addition, inflammation can develop at the site of injury, additionally creating pain signals. In some particularly difficult cases, the nerves themselves are damaged, while the pain increases.
Referred pain (locally). This phenomenon is verified by the fact that when pressing on the chin at the fracture site, pain occurs. This phenomenon is possible with fragmental irritation of the nerves.
The damaged jaw is mobile, the usual closing of the jaws is difficult, the relief of bones and skin is changed. This can be determined both by external examination and by palpation, but any touch should be done with extreme caution.
Teeth can move from their places, gaps and gaps can form between them.
Both with open and closed fractures can be damaged blood vessels the bone itself, the surrounding soft tissues, and the periosteum. Depending on the location of the injury and its cause, blood is either poured into the oral cavity or through the skin if the fracture is open. At closed injuries blood accumulates where the impact has occurred, forming clots and provoking pastosity. Bleeding is a reason for an immediate medical examination.
Puffiness of the entire contour of the face, the formation of asymmetry are signs of a jaw fracture. Edema is caused by anti-inflammatory agents that act on the vessels. They, in turn, expand, acquiring the property of greater permeability to blood. Manifestations of edema: pastosity, enlargement of soft tissues, reddening of the skin. In this case, both part of the face in the area of injury, and half of the face, and the entire face can increase. Edema is caused not only by a fracture, but also by bleeding.
The formation of increased salivation.
Movement of teeth, occurrence.
Dropping tongue.
Damage to mucous tissues, skin in the form of wounds and abrasions of various depths. Sometimes other fractures are also detected, other parts of the face and in the neck.
It is difficult or impossible for the patient to chew, swallow, speak.
At the site of injury - hematoma, bruising.
Subjectively, the patient feels headaches, dizziness, nausea, weakness.

Kinds

The bones of the lower jaw are arranged in the shape of a horseshoe, it is easily crushed. The most common localization of fractures is the region of the coronoid process, incisors, canines, angles.

On the upper jaw, the weakest places in the structure are the closure with other bones. With minor injuries, as a rule, displacement occurs without the formation of fragments. With injuries received in the region of the upper jaw frontally, there is a risk of displacement of the fragment down and back. In case of falls, indirect impacts, the risk of fragments formation and their displacement to the base of the skull also remains.

Classification of fractures according to the severity of the lesion:

Open, in which bone fragments are displaced towards soft tissues, tearing or damaging them (mucous membranes, muscles, skin). More often observed open fractures of the lower, less often - the upper jaw. With this type, there is a high risk of bacterial damage to damaged tissues, medical care is provided immediately.
Closed, in which the bone is damaged, but soft and nearby tissues are not affected. Closed types of fracture are more often localized in the region of the branches of the lower jaw, its angle. They are easier to treat than open ones.

Classification depending on the displacement of debris

A displaced fracture is formed when strong impact traumatic force. The bones of the jaw are displaced in relation to each other and other bones. In this case, the displacement can be both sagittal and vegetative, transversal.
A fracture without displacement, in which the bone is damaged or divided into fragments, but they are not displaced, are related to each other anatomically. More often than not, these are incomplete fractures.
Sometimes this classification includes the type "with a concussion."
Comminuted, flowing with the formation of several bone fragments at once different sizes, randomly located. Characteristic for a powerful traumatic impact on the jaw. Require only treatment in a hospital, self-treatment is not permissible.
Complete, in which fragments or fragments (fragments) of the damaged bone are displaced, have a transverse, oblique slope.

Degrees complete fracture:

Single;
Double;
Multiple;
splintered.

The treatment of a complete fracture is long and complicated. An incomplete fracture is characterized by the presence of injured areas of the jaw with fragments, which, in turn, are not displaced.

Types of injuries of the jaw bones according to Lefort:

Lefort - I. The boundaries of the injury pass along the base of the nose, then along top wall orbits and zygomatic arches. Otherwise, it is called subbasal. In the patient's medical history, there are complaints of visual bifurcation of objects, pain when swallowing. This fracture is characterized by swelling, characteristic symptoms of the eyes.
Lefort - II. The boundaries of the fracture are located along the base of the nose, the lower wall of the orbit, then along the zygomatic-maxillary junction. suborbital type. With it, some parts of the face become numb, tears are released, bleeding from the nasopharynx is characteristic.
Lefort - III. The boundaries of the fracture pass along the base of the pear-shaped opening, the bottom maxillary sinus. Bottom type. The patient will complain of pain, difficulty chewing, bleeding, bite difficulties.

By location, fractures are divided into:

Medium - in the region of the central incisors.
Incisor - between the lateral and first incisors.
Canine - on the line of the canine.
Mental - in the area of \u200b\u200bthe chin hole.
Angular - in the area of the angle of the lower jaw.

In relation to the place of impact, fractures are divided into direct (directly in the area of injury), indirect (in the opposite place).

First aid

On-site medical care, pending qualified care, should be provided as quickly as possible. The basic rules are:

provide complete rest to the patient in a motionless state;
restore breathing (cardiopulmonary resuscitation if necessary);
offer analgesics;
remove all excess from the oral cavity;
disinfect the wound;
stop the bleeding;
with minimal knowledge, try to combine the bones.

Jaw fracture - treatment

Any kind of injury, both the upper and lower jaw, is treated in a surgical hospital. In complicated cases, surgery is indicated.

Upon admission, the patient is anesthetized, a bandage is applied to him, diagnostics are carried out (X-ray, CT, MRI), bone structures are restored with sutures, staples, plates. Implants are installed if it is not possible to assemble the patient's bones together. Treatment includes antibiotic therapy, physiotherapy. The main methods of treatment are splinting and shunting.

Splinting

Bone fragments are adjusted using a special plastic device. In case of a fracture on one side of the face, the device will be applied on the same side, in case of a complicated one - on both sides with the addition of special rings and hooks.

In case of injury of both jaws, complicated by the displacement of fragments, splinting is performed on both jaws (two-jaw technique). the main objective method - ensuring the immobility of healing tissues. Treatment may take up to 2 months. Before the tires are removed, the patient is given an X-ray to make sure that the tissues have healed.

Shunting

The method is used in complicated cases. In this case, the injured bone fragments are fixed with special splints, consisting of hook loops and rubber intermaxillary traction (Tigerstedt's splint).

The method allows, in addition to fixation, to reduce the load on the patient's bones.

Food

Even with simple fracture the patient has difficulty eating. Depending on the severity of the injury, the patient is selected a method of nutrition with auxiliary measures.

Drinkers with tubes are used in the absence of part of the teeth. It is injected directly into the stomach. Food should be moderately warm, served in small portions, fractionally. The method is suitable for home conditions.
Probes are used strictly in hospitals in the first weeks. The probe is inserted into the stomach.
Dropper for parenteral food intake if the victim is unconscious.
Enemas for nutrition are used in unconscious states and with difficulty feeding the patient through the veins.

What can you eat with jaw damage:

high-calorie meat dishes, diluted with milk or broth in a pureed form;
children food;
milk and sour-milk liquid drinks;
broths;
puree soups;
fruit, vegetable puree and soufflé;
porridge diluted with milk.

Important: the diet must compensate daily requirement patient in calories.

Video: how to eat with a broken jaw? Personal experience video blogger. You can also find other tips on his channel.

Effects

Without unpleasant consequences jaw fractures usually do not go away. Injuries can result in:

Complications can be avoided by timely handling to professionals.

Rehabilitation

Recovery after surgery or treatment includes physiotherapy, exercise therapy, oral hygiene.

Physiotherapy exercises are prescribed no earlier than a month after the tires are removed. It is important to restore chewing function, swallowing, facial expressions.

Effective physiotherapy methods such as exposure to electromagnetic fields of different frequencies, pulsed magnetic therapy, ultraviolet irradiation, electrophoresis, ice application, microwave therapy, paraffin therapy, infrared irradiation, massage of the collar area.

Additional questions

How long does it take for a fracture of the lower and upper jaw to heal?

In the absence of complications, such as traumatic osteomyelitis, inflammatory processes, lighter fractures heal from 30 to 45 days. Injuries of the lower jaw are often more complex than those of the upper jaw. Restoration of bones can take up to 60 days.

Does it hurt to remove splints after a jaw fracture?

The process of getting rid of tires is less painful than the development of muscles and tissues after injury and immobilization. During the rehabilitation, the muscles partially turned up rigidity, the patient will experience pain during eating, swallowing, speech.

How to determine a jaw fracture or bruise?

Common signs of injury are bruising, soreness, swelling, and bruising. At the same time, it is with a fracture that speech is difficult, the pains are more pronounced, the patient feels a clear weakness up to loss of consciousness. Accurate Diagnosis will be established only by the surgeon after x-ray.

How many are in the hospital?

Length of stay in hospital varies different fractures. Complicated fractures, with displacement, surgical intervention, will require a course inpatient treatment up to 4 weeks.

The main task of a dental surgeon during the treatment of a fracture of the upper or lower jaw is to restore anatomical structure broken bone and the correct ratio of the dentition. Many methods help to achieve this, however, the effectiveness of treatment also depends on how correctly and quickly first aid was provided.

Before hospitalization

First aid to the victim includes:

stopping bleeding (pressing or packing a wound, applying cold);
if necessary cardiopulmonary resuscitation;
anesthesia (analgin, revalgin intramuscularly);
immobilization of the jaw with fixing bandages (contraindicated if the victim is unconscious, as this increases the risk of suffocation from retraction of the tongue or ingestion of vomit into the respiratory tract).

Treatment Methods

Operative, or the method of osteosynthesis, consists in fastening fragments of the jaw with special, often metal, structures.
Conservative, or orthopedic - involve the use of special splints that fix the fracture site.

Osteosynthesis

Indispensable for complex, splintered and multiple fractures misaligned, loose teeth and total absence teeth, with periodontitis and other inflammatory diseases gums in the area of injury. Also, osteosynthesis is effective in fractures of the condylar process, complicated by dislocation of the articular head of the lower jaw.

The fastening materials can be steel knitting needles and rods, pins, nitride-tinane wire with shape memory, fast-hardening plastics, polyamide thread, special glue.

However, the most convenient and safe method Today, osteosynthesis with metal miniplates is considered. They allow you to dissect the skin and muscles on one side only, which simplifies the operation itself and reduces the recovery time. Another indisputable advantage of them is the ability to reliably fix fragments in areas with significant dynamic loads.

Splinting of the jaw

This is the immobilization (fixation) of bone fragments using a special plastic or wire structure.

The technique, created by military doctors at the beginning of the 20th century, is successfully used by dentists today. Tire manufacturing materials have changed, methods of its imposition have been improved.

Today, there are many types of tires in the arsenal of a specialist:

from standard Vasiliev band splints, the simplest and cheapest treatment method;
up to the Tigerschdedt aluminum splints, which are performed individually for each patient, due to which they are more effective. In addition, they evenly distribute the load and minimally injure the teeth.

The type of splinting depends on the type of injury and can be unilateral (with a fracture of one jaw) or bilateral (when both are damaged).

If the teeth are preserved, it is not difficult to apply a bent tooth wire splint. It is bent according to the shape of the dental arch and fixed with bronze-aluminum wire ligatures, which, like a hairpin, cover the tooth on both sides. Manipulations are performed under local anesthesia.

When both jaws are fractured, a structure with a more rigid base is installed, in addition to the wire, hooks and rings are also used to immobilize the lower jaw.

Is it possible to do without splinting?

Even if the case is not severe - the fracture is unilateral, closed and without displacement - it is imperative to take measures to exclude the development of such unpleasant complications, how:

accidental displacement of fragments,
re-injury,
the development of soft tissue inflammation,
fracture site infection.

For this, it is necessary to immobilize the jaw with any accessible method. It can be a sling bandage, but it is much more convenient and efficient to use a splint. With a complicated fracture, splinting is indispensable, regardless of the site of injury.

What will happen to the tooth at the site of injury?

If it is mobile, fragmented, dislocated, or prevents the jaw fragments from being repositioned, it will have to be removed. The same fate awaits the tooth in the presence of periodontal disease, cysts, granulomas and other inflammations. In other cases, the teeth can be saved, but require careful observation.

Management of a displaced fracture

In such cases, before applying the splint, it is necessary to compare the fragments of the jaw, for which purpose the correcting orthopedic devices are used. A broken upper jaw requires traction with special splints.

Such injuries are very dangerous because they can cause asphyxia. But properly rendered first aid will prevent suffocation. Clean the oral cavity from foreign bodies or blood, lay the victim face down, placing a roller rolled up from clothes, blankets, etc.

Rehabilitation after a jaw fracture

For successful treatment fracture of the jaw, anti-inflammatory and restorative therapy, physiotherapy, mechanotherapy and special oral hygiene are also important.

Within 3-4 days after the injury, antibiotics must be prescribed to prevent inflammation, which are injected directly into the area of damage.
General strengthening therapy is the intake of vitamins C, P, D and group B, drugs that stimulate tissue regeneration and restore the level of leukocytes in the blood.
Among the effective physiotherapy, we note UHF therapy, general UVR, magnetotherapy. Already after the third procedure, swelling and soreness are noticeably reduced, the swelling subsides. For better passion of fragments, 2 weeks after a jaw fracture, electrophoresis is performed using a two to five percent solution of calcium chloride.
mechanotherapy, or physiotherapy, accelerates the restoration of jaw function, helps if, after an injury, the mouth does not open well or does not open at all. It can also be practiced at home, starting from 4-5 weeks after the fracture, when the tires are removed and the callus is formed.
Special hygiene involves irrigation at least 8-10 times a day. Victims who are unconscious are treated with a special solution at least twice a day for teeth and mucous membranes.

How to eat?

Because during intensive care and during the recovery period, the jaws are rigidly fixed and habitual chewing of food is out of the question; during this period, correction of the diet is necessary.

Food should be the consistency of low-fat sour cream. These are broths, pureed soups, carefully chopped vegetables and fruits, milk drinks, liquid cereals. Spices are excluded, the use of salt is limited. The temperature of the dish should be no higher than 45-50 ° C. It is most convenient to eat food through a straw.

It is necessary to gradually switch to the usual diet after removing the tire. This is important not only for the restoration of chewing functions, but also for the prevention of disorders in the digestive tract.

When are the splints removed, and how long does the jaw heal?

The older the patient and the more complex the fracture, the longer the rehabilitation period will be required. Approximately it is from 45 to 60 days. Splints are removed on the 30-45th day, if the treatment did not include osteosynthesis, and on the 5-14th day after it.

How much does it cost to treat a broken jaw?

The price depends on the nature of the injury, whether osteosynthesis was performed, what splints were used, whether the patient attended physiotherapy procedures. But let's say for sure that the service is not cheap. Only osteosynthesis will cost from 14,000 to 55,000 rubles.

It is also necessary to take into account the cost of the subsequent dental treatment to restore lost or damaged teeth after splinting. Our service will help you choose a competent specialist and not waste your money. Compare prices and services various clinics Read testimonials from real patients.

Dislocation and fracture of the lower jaw - serious injury that require immediate medical attention. They occur most often as a result of falls, fights, accidents, but in some cases they are the result of certain diseases. What are the symptoms of a fracture and dislocation of the lower jaw, how is the treatment, you will learn further.

Features of dislocations of the lower jaw

Dislocation of the jaw is the result of sustained pathological displacement the articular head from its normal position, resulting in pain and disruption of the functioning of the jaw. Its mobility is limited and pain occurs.

Dislocation can occur only with the lower jaw, since the upper one is absolutely motionless. The lower jaw is attached to temporal bone with the help of the temporomandibular joint, which sets it in motion.

The head of this joint is able to slip out of its normal location and be in front of the tubercle of the temporal bone. This problem usually occurs after sudden movements or various injuries.

According to statistics, jaw dislocation is more common in women than in men. This is due to the peculiarities of the structure of the temporomandibular joint: in men, the joints are more secure due to the deep glenoid fossa.

Depending on the nature of the damage and their causes, the dislocation can affect both one side of the jaw, and both at once. That is why at the stage of diagnosis it is necessary to do X-ray the entire facial part of the skull. If you have dislocated your lower jaw, you need to seek medical help as soon as possible, as this injury can lead to unpleasant consequences:

weakening of the ligamentous-capsular apparatus,
joint deformity,
changes in the shape, size and structure of the discs.

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, dental treatment for children and adults

The reasons

Dislocations are most common in women

This injury can happen for several reasons:

cry,
strong yawning,
during vomiting
trying to bite off a big piece,
bad habit of opening bottles and packaging with teeth,
strong blows (this is often faced by boxers and other athletes).

But some diseases can also lead to injury:

arthritis,
arthrosis,
osteomyelitis,
gout,
polio,
rheumatism.

These diseases provoke weakening of the ligaments, as a result of which the height of the joint decreases, and its shape is also deformed.

Symptoms

Regardless of the causes of jaw dislocation, there are several symptoms that make it possible to accurately diagnose the type of injury:

difficult to open - close the mouth,
speech difficulty,
profuse salivation,
facial symmetry distortion
pain in the lower jaw, which radiates to the temple area,
the patient cannot speak clearly, as he cannot close his mouth completely.

Important: in no case do not try to straighten the jaw yourself, by doing this you can only aggravate the situation. Contact a specialist as soon as possible. Cold will help ease the pain, you can also temporarily support the lower jaw with a handkerchief or scarf.

Types of dislocations of the lower jaw

Unilateral

This type is rare: the head of one joint is displaced from its normal position, as a result of which the mouth opens and the jaw moves towards the healthy side.

Bilateral

This type injury is the most common. Result: The mouth is fully open and the lower jaw is pushed forward. A person cannot swallow and talk normally, and there is also profuse salivation.

Full

This type of dislocation is characterized by the fact that the joints do not touch.

Incomplete

It is also called subluxation. Articular surfaces are partially in contact with each other.

Habitual

If the dislocation occurs as a result of normal yawning or slight pressure on the jaw, it is called habitual. Such a dislocation occurs as a result of the anatomical features of the structure of the jaw:

flat articular tubercle,
weakened ligamentous apparatus joint.

You can deal with this injury on your own. But only surgical intervention can prevent the recurrence of such troubles.

Rear

Such an injury in most cases is the result of a strong blow to the chin. Bottom line: the lower jaw moves back. This type of dislocation is very dangerous, as it often leads to joint rupture and damage. ear canal. The person may start bleeding in the ear.

Complicated called a dislocation, as a result of which there was a rupture of soft tissues.

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Treatment

The presence of a dislocated jaw can be diagnosed using x-rays, as well as visual inspection sick. Anterior dislocation can be reduced in several ways:

Hippocratic method is carried out as follows:

the patient is seated on a low chair,
the back of the head must be firmly supported,
doctor wraps his thumbs towel and places them on chewing surface molars,
with the rest of the fingers, the doctor captures the jaw from below,
carefully, pressing the thumbs downwards, and the rest upwards, the doctor relaxes the jaw,
then the doctor gradually shifts the jaw back, as a result of which articular heads return to their holes
the return of the heads to their usual places is accompanied by a characteristic sound - a click, as well as a reflex closing of the jaws, so the doctor must have time to remove the thumbs from the patient's mouth so as not to injure them.

Hippocratic–Khodorovich Method

Since the fingers wrapped in a towel become cumbersome, P.V. Khodorovich proposed his own version of jaw reduction: the thumbs should be placed not on the chewing teeth, but on the oblique outer lines of the lower jaw so that the fingers rested on the edges of the jaw branches.

Blechmann-Gershuni method

This method provides 2 options for jaw reduction:

the doctor should feel with his fingers the processes of the bone that have shifted, and press them down and back at the same time,
external method: the doctor finds displaced processes with outside face, near the cheekbones. It is necessary to press in the same way: down and back. This method is faster and easier.

Popescu Method

This method is applied in extreme cases when no methods help, or the person has old dislocation. Reduction takes place under local or general anesthesia Depending on the severity of the injury:

the patient is placed on his back,
between chewing teeth the lower and upper jaws are located rollers with a thickness of at least 1.5 cm,
then the doctor presses on the chin in the direction up and back,
the joint usually falls into place.

If this method did not help, the operation is performed.

Treatment of habitual dislocations

For the treatment of habitual dislocations, special mouth opening restraints are used, which are of 2 types:

Such a limiter rests on the front edge of the jaw branch, as a result of which an obstacle is created for the movements of the lower jaw.
This device works by intermaxillary articulation.

The duration of treatment with such devices is usually about 2-3 months. In addition, the following procedures can be carried out in combination with the use of limiters:

Blockade of chewing muscles.
Massage.
Medical therapy.
Normalization of interalveolar height.
Prosthetics of missing teeth.
Physical exercises.
Grinding of some teeth.

What to do after treatment?

After you have adjusted the dislocation, it is imperative to follow some recommendations:

must wear a supportive bandage,
in the first days after the manipulation, it is better to eat yogurt, soups and mashed potatoes,
try not to open your mouth wide
bite food into small pieces
while yawning, you must be very careful.

If you have had a dislocated jaw at least once, you should report it to the dentist before starting treatment to avoid re-injury.

Fracture of the lower jaw

A fracture of the jaw is a violation of the integrity of the bones of the lower jaw. The most common fracture is the result mechanical injuries: accidents, fights, falls. The fracture can occur anywhere in the jaw and is more common in men than women.

There are typical fracture sites, those where the strength of the bone is low and it has a large load.

The most common types of fractures are:

mental hole projection,
projection of the third molars,
articular process,
middle part of the jaw.

Mandibular fracture symptoms

Mandibular fractures often result from fights

Regardless of the location of the fracture, the following symptoms occur:

a gap between the teeth may form at the site of the fracture,
facial deformity,
swallowing and chewing functions may be impaired,
the area of the chin and lips loses sensitivity, becomes numb,
general malaise,
acute pain
mobility or displacement of bone fragments,
displacement of the teeth.

A fracture of the lower jaw can be accompanied by more serious symptoms:

ear bleeding,
concussion,
loss of consciousness.

If a fracture occurs alveolar process, the main symptom will be impaired speech.

Types of fractures

Fractures of the lower jaw are classified according to the nature and causes of damage:

Complete fracture

As a result of such an injury, bone fragments are displaced. They can be oblique or transverse, it all depends on the line of the fracture. By the number of fractures can be:

double,
comminuted,
multiple.

incomplete fracture

In an incomplete fracture, there is no displacement of the bone.

Open fracture

Accompanied by rupture of facial tissues and mucous membranes of the oral cavity.

Closed

The fracture site remains intact, tissues and mucous membrane remain intact.

First aid

Emergency care for a person with a fracture of the lower jaw consists of the following activities:

Asphyxia warning.

The person must be laid on their side. If the patient has lost consciousness, it is necessary to ensure that his tongue does not sink.

Antishock therapy.
Stop bleeding.
It is necessary to transport the patient to a medical facility.

Diagnostics

The diagnosis is made by the doctor after a thorough examination. Typically, a specialist determines a jaw fracture by the following symptoms.