What happens when the jaw is broken. Types and complete classification of jaw fractures, as well as how long does it heal? Mandibular fracture treatment methods
Dislocation and fracture mandible- Serious injuries requiring immediate medical attention medical care. 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 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 articular 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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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, causing the mouth to open and the jaw to move 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 partly 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. This dislocation occurs as a result anatomical features jaw structures:
- 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 the articular heads return to their fossae,
- 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 bottom and upper jaw rollers with a thickness of at least 1.5 cm are located,
- then the doctor presses on the chin in the direction up and back,
- the joint usually falls into place.
If this way 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 jaws.
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.
The most common facial injury is a fracture of the jaw, and in general, the bones of the jaw are among the ten most commonly broken bones. human body. It should also be noted that fractures most often occur on the lower jaw and they are double or even triple. This is due to the horseshoe-shaped jaw. How to help a person if you suspect that his jaw is broken, and who to turn to for help?
Causes and symptoms
All the reasons why a fracture of the lower or upper jaw occurs can be divided into several groups. The first group is traumatic fractures, these include road traffic accidents, physical violence (assaults), falls, sports injuries. The second group - pathological fractures that occur as a result of certain diseases, such as, for example, osteomyelitis, a tumor, that is, when the bone is pathologically changed.
Tomography of a mandibular fracture.
So, how do you know if a person has a broken jaw? The following symptoms are distinguished:
- the first signs are severe pain;
- a person immediately experiences symptoms such as the inability to fully open the mouth, impaired speech and bite (upper and lower teeth do not match)
- symptoms associated exclusively with a fracture of the lower jaw - numbness of the lower lip and chin;
- in addition, signs of severe hematoma under the tongue, bleeding in the oral cavity can be detected.
To find out accurate diagnosis, the doctor takes an x-ray, examines the face, palpates the jaw through the skin, checks the mobility of the jaws and makes several simple tests. For example, the doctor may ask the patient to clench their teeth, or place a flat piece of wood between the patient's teeth to see if the patient can hold it with their teeth.
Classification
As mentioned above, jaw fractures are divided into traumatic and pathological, but besides this, there are several more classifications of fractures:
- depending on the degree of damage, fractures are complete and incomplete (cracks, indentations);
- the fracture line can be oblique, transverse and zigzag;
- regarding the place of impact, fractures can be direct, that is, located directly at the site of impact and indirect, localized on the opposite side from the impact;
- according to the number of fragments, fractures are divided into double (the bone is broken in one place), multiple (several large fragments) and comminuted (many small fragments);
- in addition, the fracture can be both open and closed;
- classification of fractures of the lower jaw: fracture of the canines, incisors, coronoid processes, fracture in the area of the angle (in other words, it is called an angular fracture of the lower jaw).
Seventy percent of all jaw fractures occur in the lower jaw. The weak points of the lower jaw include the zone of the angle in the area of the third molar and the zone of the mental section in the area of the canine.
Single fracture of the lateral part of the mandible
AT this case two fragments are formed, and the smaller fragment is displaced upwards under the action of muscle strength, and the larger one - upwards and to the side (fracture with displacement). Often the consequences of such an injury are loss of sensation in the chin and lower lip. Treatment begins with stopping bleeding (which is usually very strong), repositioning bone fragments and fixing them in the desired position.
Single fracture of the lower jaw in the area of the angle
There is such an injury between the third large molar and the second molar. This is also a fracture with a displacement: the smaller fragment not only moves upward, but also rotates along its axis (the base of the angle is outward, the front edge is inward).
Possible sites of fracture of the lower jaw (indicated by a zigzag).
Transverse fracture at the angle
A fairly rare injury. If the cross-sectional area of the broken bone is wide enough, displacement can be avoided; if not, a fracture with displacement will occur, the larger of the fragments will move down and turn around on its axis. The more the position of the lower fragment changes, the more significant will be the speech defects in the patient. The danger of this fork of injury is that in the area of the angle of the jaw, between fragments of a broken bone, muscle fibers often fall.
Bilateral mandibular fracture
There is a division of the bone into three parts with a displacement of the middle part down, in the lateral parts up and inward. A double fracture of the lower jaw has consequences such as retraction of the tongue, difficulty breathing.
upper jaw
Only 30% of all jaw fractures belong to fractures of the upper jaw. Such a fracture occurs along one of the lines described by Le Fort. These lines are named after him:
- one lefort, the lower line is directed from the base of the pear-shaped aperute to the pterygoid process of the sphenoid bone;
- lefort two, middle line - passes through the nasal bones, the bottom of the orbit, the pterygoid process of the sphenoid bone;
- lefort three, upper line (weak point of the upper jaw) - passes through the nasal bones and is directed to the zygomatic arch.
At its core, a fracture of the upper jaw is a very dangerous injury, because it can have such consequences as osteomyelitis, meningitis, concussion. The higher the fracture line of the upper jaw, the more severe the patient's condition and the more likely occurrence of unpleasant consequences.
Fractures of the upper jaw are divided into three types, depending on their complexity.
First type
The first type is characterized by a break under the arch of the sky, this type is accompanied by a break of the bottom and, quite often, a fracture of the nose. The main symptoms of such a fracture are a violation of the symmetry of the face (swelling of the lips, cheeks, nose) and bleeding between the lips and teeth.
Second type
Part of the upper jaw and nasal bones were torn off from the base of the skull. The fault line passes through the wall of the orbit and the bridge of the nose. The symptoms of such a fracture are much more significant. This is numbness of the skin under the eyes, and loss of smell, and severe hematomas under the eyes (from the side inner corner eyes and lower eyelid), and excessively profuse salivation and nosebleeds. In addition, the x-ray will clearly show violations of the bone structure in the region of the nose.
The second type of fracture of the upper jaw.
Third type
Complete avulsion of the upper jaw, accompanied by a fracture of the base of the skull. The detachment passes along with the bones of the cheekbone and nose along inner wall eye sockets.
Signs of such an injury are impaired vision, the inability to open the mouth normally, a significant violation of the symmetry of the face, hematomas around the gas (unlike the previous type, hematomas do not appear in the corners of the eyes, but, as it were, in the shape of glasses), the displacement of the eyeballs down and abnormal dilatation of the palpebral fissure.
Treatment
If a person has a broken jaw, doctors will treat her in several stages, each of which is extremely important in order to avoid dangerous consequences:
- treatment begins with anesthesia, anesthetics are injected into the fracture site;
- after that, it is necessary to stop the bleeding, if you need to provide first aid to the victim - press the bleeding vessel to the bone or apply ice, while doctors stop the bleeding by applying stitches or bandages;
- further, suffocation should be prevented - with bilateral fractures of the lower jaw, the tongue may fall inward, the tongue must be carefully removed from the respiratory tract and held with a napkin or gauze;
- the most important stage in the treatment - the reposition of the debris - is used here various treatments: bone sutures using wires, metal staples, plates, sometimes doctors use special fixing devices, if it is impossible to restore the bone, surgeons can use implants made from natural or artificial materials;
- after the reposition of the fragments, immobilization is carried out, for this, wire or plastic splints are used, or ordinary fabric bandages;
- antibiotic treatment is used if the fracture is open, or if it passes through the hole of the tooth - this is also one of the milestones in treatment, because through the wound they can penetrate the body pathogenic bacteria that will lead to traumatic osteomyelitis;
- the next moment in treatment is the special nutrition of the patient, it should be understood that with a fixing bandage, the patient simply cannot take solid food therefore, the patient's nutrition should be semi-liquid or liquid, but at the same time containing enough nutrients, proper nutrition should be reckoned with the passage of a course of vitamin therapy;
- and finally The final stage in treatment - physiotherapeutic procedures - this is a period of rehabilitation and prevention of the occurrence of dangerous consequences.
Physiotherapy
Since physiotherapy is key point during the period of recovery of the patient's health, we will dwell on it in more detail.
Doctors offer to treat the patient after providing the necessary medical care by the following methods:
- applying ice on the second or third day after treatment;
- UV irradiation (at severe pain and violation of the integrity of the skin);
- microwave therapy for small edema;
- UHF electric field (on the second or third day to remove severe swelling and pain relief)
- paraffin therapy;
- infrared irradiation (on the fifth or sixth day);
- electrophoresis for pain relief (for seven to ten days);
- massage of the collar region (starting from the fifth or sixth day after the fracture).
In addition to the basic physiotherapy, sometimes doctors prescribe additional ones, for example, mud therapy, ultrasound, paraffin baths.
Jaw fracture is an injury bone tissue jaw due to violation of its integrity. The lower jaw is most commonly affected. The share of fractures of the lower jaw accounts for up to 70% of all cases of fractures of the facial bones.
The main cause of a jaw fracture is trauma caused by a blow, fall, gunshot wound. In addition to trauma, a fracture may be the result of a disease that affects the bones: neoplasm, osteomyelitis, tuberculosis, syphilis, etc., as a result of which spontaneous or unauthorized, without external influence, fracture of the jaw.
Types of fractures
Jaw fractures are distinguished depending on the nature, number of fragments, fracture line and mechanism of occurrence.
The nature of the fractures are:
- closed - the integrity of the skin and tissues around the fracture is not damaged;
- open - accompanied by damage to the mucous membrane and other tissues in the area of the fracture;
- complete - with displacement of jaw fragments;
- incomplete - displacement of jaw fragments does not occur.
By the number of wreckage, lesions are:
- single;
- double;
- triple;
- multiple.
Depending on the line of damage, fractures are:
- straight;
- transverse;
- longitudinal;
- zigzag;
- oblique;
- splintered.
In addition, fractures of the upper and lower jaws are classified separately.
Fracture of the upper jaw, there are three types, which are determined by the line of the fracture, there are three types:
- bodies of the upper jaw;
- complete detachment of the upper jaw;
- complete detachment of the bones of the facial skull.
Also fractures of the upper jaw include a fracture of the zygomatic bone and its arch.
Fracture of the lower jaw, depending on the location, it happens:
- middle;
- canine;
- incisive;
- mental;
- angular;
- body of the jaw;
- jaw branches;
- cervical;
- coronary;
- base of the condylar process.
Symptoms of a jaw fracture
Depending on the location of the fracture of the jaw and its nature, the corresponding symptoms appear. In addition to the obvious signs open fracture there are symptoms of fractures of the upper jaw and lower.
Symptoms of a fracture of the upper jaw:
- severe pain in the area of injury;
- labored breathing;
- it is difficult and impossible to speak and chew;
- possible nausea and vomiting;
- with a fracture under the palatine vault, with a fracture of the nose and damage maxillary sinus:
- swelling of the cheeks, mouth and nose;
- bleeding between teeth and lip;
- when separating the upper jaw from the base of the skull, with the intersection of the fault lines of the bridge of the nose and the orbit:
- numbness and bruising under the eyes;
- violation or total loss smell;
- nosebleeds;
- possible uncontrolled salivation;
- with a detachment of the jaw and a fracture of the base of the skull:
- inability to open the mouth;
- facial asymmetry;
- hematomas around the eyes in the form of glasses;
- blurred vision and lowered down eyeballs.
Mandibular fracture symptoms:
- swelling and redness of the skin in the area of damage;
- increase in body temperature;
- asymmetry of the face;
- sharp pain when touching the damaged area;
- increased pain when trying to move the jaw;
- possibly shortness of breath due to overlapping of the airways with the tongue;
- inability to completely close the mouth;
- bite problem;
- possible displacement of the jaw;
- increased sensitivity of the teeth;
- there may be blood in the saliva.
Diagnosis of a jaw fracture
It is not difficult for a surgeon to diagnose a jaw fracture. After examination, the victim must be sent to x-ray examination. A picture of the jaw is taken in three projections. In addition, especially with strong traumatic injury jaw to make sure that the spinal cord is not damaged, an x-ray is taken cervical spine. Also at severe injuries to exclude intracranial bleeding, a number of measures are taken to diagnose it.
First aid for a broken jaw
The first thing to do in case of a jaw fracture is to call ambulance. Until the ambulance arrives, the first priority is to control vital functions. When bleeding, you need to stop it, for this it is desirable to use a sterile material, the wound must be pressed or closed with a swab. With difficulty breathing, the main thing is to control the patency of the airways. To do this, the victim in consciousness must be planted, and unconscious - put on his side and put a cushion or pillow under his head.
If the tongue sinks, it must be fixed. When the victim is not breathing, he is given artificial respiration. In case of a simple fracture of the lower jaw, it is necessary to immobilize and fix the jaw: carefully bring the lower jaw closer to the upper; make a bandage that goes under the chin and is fixed on the top of the head. Lay the victim down and wait for the ambulance to arrive. In the future, in order to avoid serious negative consequences, you can not self-medicate.
Jaw fracture treatment
Treatment of a jaw fracture is carried out only by a doctor in a hospital setting. The main measures in the treatment of this injury are aimed at combining the bones, comparing the fragments and fixing the jaw with special splints. In some cases, fixation is carried out using metal plates fixed with screws. This procedure is carried out through surgical intervention. Sutured for open fractures big wounds and processed minor damage. For any fractures of the jaw, regardless of complexity, anti-inflammatory therapy is prescribed.
Which doctor should I contact?
A traumatologist and a maxillofacial surgeon are involved in the treatment of a jaw fracture.
- This is a trauma to the face, with damage to the integrity of its bones. Occurs when the intensity of the traumatic factor exceeds their strength. This damage is common, any injury can be the cause: strong blows to the face, falling on a hard surface.Most often, traumatologists observe a fracture of the articular process, although there are injuries in the region of the angle of the lower jaw, in the middle of the body of the lower jaw bone, in the projection of the mental process. The fracture can be complete or not, open or closed.
Signs of trauma are obvious: a person is unable to open his mouth wide, when he tries to talk, he experiences pain, the bite changes. Sometimes there may be double vision, numbness of the face, deformity of the cheekbone. Full list symptoms will depend on the nature of the injury and its location.
Fracture of the lower jaw
If we talk about a fracture of the lower jaw, then the main types of such an injury should be considered:
A complete fracture is considered when the fragments of the jaw have been displaced. They may vary in shape and quantity.
A fracture is called incomplete when no displacement is observed.
At open injury the mucous membranes of the mouth are damaged, and soft tissues faces.
At closed injury the bone does not break through adjacent tissues, but remains inside them.
Comminuted fracture the jaw is rarely observed, since it requires the application of incredible force to occur. He needs mandatory surgery.
The following signs are characteristic of a mandibular fracture:
Swelling and hemorrhage in the damaged area and the asymmetry of the face caused by these phenomena. , as a rule, strong, with reddening of the skin and an increase in its temperature. When the fracture is closed, blood accumulates in the soft tissues and forms a clot. In an open injury, more blood enters the oral cavity than to the external environment. How stronger blood loss, topics larger vessel was damaged, and the faster the first aid and delivery of the victim to a medical facility is required.
Sensation of pain when touched. It intensifies when you try to talk, as the periosteum is damaged.
Displacement of fragments of varying degrees of severity, their mobility.
Change in bite.
Increased sensitivity and electrical excitability of teeth.
Depending on where the injury is localized, there are:
Fracture passing through the center of the incisors - median.
The injury between the first and lateral incisors is incisal.
A fracture localized in the canine region is a canine fracture.
The injury opposite the chin is mental.
Injury to the body of the jaw, the one that is located between the 5th and 8th teeth.
In the upper third of the jaw - a fracture of the branch of the jaw.
Fracture of the base of the condylar process.
A cervical fracture, that is, one that is located near the process of the jaw (condylar) and a coronal one, located near the coronoid process.
First aid, if a person has received a fracture of the lower jaw, is as follows:
To begin with, the jaw must be fixed. This is done with a bandage. Under the teeth, you need to put a flat hard object, for example, a ruler. Then the lower jaw is pressed against the upper jaw and immobilized by wrapping it with a bandage. If a person is not conscious, then this cannot be done, since it will be possible to skip swallowing the tongue or getting into Airways vomit masses.
If there is bleeding, then it must be stopped. To do this, it is pressed or plugged with a clean, preferably sterile material. If you additionally act on the site of injury with cold, then this will help reduce blood, and also somewhat alleviate the pain symptom.
It is important to leave the oral cavity clean from possible fillers, in particular: blood clots and vomit.
Try not to disturb the person before the arrival of the medical team. It is better that he sits, if this is not possible, then you can lay him face down or on his side.
When strong pain need to lighten them. For this, analgin, revalgin, naproxen are used. Since a person with such an injury will not always be able to swallow a pill, it is necessary to crush it into powder and, having dissolved in water, give the victim a drink. It will be even more effective intramuscular injection, but, as a rule, when providing first aid, it is rarely possible to do it. It will help alleviate the condition and the cold, which will narrow the blood vessels, reduce swelling and pain. But before applying ice, it must be wrapped with a cloth.
After carrying out these activities, the person must be taken to medical institution for further professional therapy. An x-ray is used to diagnose a fracture. Since this is a serious injury, often accompanied by a spinal injury, an additional x-ray of its cervical region is often prescribed before starting treatment. This is done to prevent damage. spinal cord. It is also necessary to make sure that the person does not have a concussion and intracavitary cranial bleeding.
Fracture of the upper part is somewhat less common and accounts for up to 30% of all cases of jaw damage.
It is classified according to the line of fracture:
The lower line (lefor one) has a direction from the beginning of the pear-shaped aperut to the process of the sphenoid bone (pterygoid).
The middle line (lefort two) runs along the bones of the nose, capturing the bottom of the orbit and the pterygoid process.
The top line (lefort three) is directed to the cheekbone, through the bones of the nose.
The danger of injury lies in its consequences, which can be expressed in, concussion and. The higher the break line is, the more often undesirable consequences occur.
Signs of a fracture of the upper jaw, depending on its type:
If there is a fracture under the palatine vault, with a fracture of the maxillary sinus and a fracture of the nose, the victim has swelling of the cheeks, nose and lips, with severe bleeding between the lip and teeth.
If part of the upper jaw is torn off from the base of the skull, and the fault line crosses the orbit and bridge of the nose, then there is numbness of the area under the eyes, and pronounced hematomas in the same place. Blood flows from the nose, often it is impossible to stop salivation. The sense of smell is either completely absent or significantly impaired.
If, the separation of the jaw is supplemented by a fracture of the base of the skull, then the function of vision will be impaired, the mouth will not open. The face will be asymmetrical, reminiscent of glasses, eyeballs are lowered down.
Regardless of the type of fracture, the person often experiences nausea, vomiting may occur, the bite will be disturbed, and pain pronounced. All other functions are difficult, somehow: respiratory, chewing and speech. A concussion almost always accompanies this injury.
First aid, in addition to the basic measures in the form of immobilization, anesthesia and bleeding control, should be supplemented by the restoration of respiratory function. To do this, it is necessary to remove all foreign objects from the mouth, in particular, fragments of teeth and vomit. If a person feels sick, then you should immediately put it on its side, or face down.
Displaced jaw fracture
In case of a jaw fracture, the displacement of fragments can be observed in three directions: sagittal, vertical and transversal. It is they who play a decisive role in determining the tactics of treatment and choosing the device that will be used to reduce them.
The most commonly used tires are made of wire, with fixation by the teeth. The bones are collected manually by the surgeon, the patient at this time can be under both local and general anesthesia. Fixation of fragments can also be carried out using a nylon vein. Next, the jaw is fixed with metal knitting needles or plates that are superimposed on the outside.
When fixation is carried out, the patient is advised to rest, with the implementation of antimicrobial measures.
Double jaw fracture
A double fracture of the jaw is characterized by the fact that it diverges in three directions:
The middle part of the jaw is directed downward.
Lateral go inward and upward.
This injury is dangerous because, after receiving it, a person may die from asphyxia, which will occur as a result of the tongue falling. Therefore, it is necessary to carefully monitor its condition.
Sequelae of a jaw fracture
In order to avoid the consequences of a jaw fracture, you should not self-medicate, but seek medical help as soon as possible. As complications are distinguished:
Displacement of one dentition.
The formation of pronounced gaps between the teeth, which will be located at the site of the fracture.
Strong displacement of fragments with deformation of the face, due to muscle strength.
Displacement of teeth with the occurrence of an abnormal bite.
Meningitis.
Osteomelit.
Treatment of a jaw fracture is the prerogative of a doctor. The sooner it is started, the better for the patient.
Basically, the activities are reduced to the following actions:
Treatment of an existing wound, its disinfection.
If there is a displacement of the nasal septum, then its alignment.
Comparison of possible fragments, and combination of whole bones.
Reliable fixation jaws with a special splint. It needs to be completely immobilized. A splint is applied for up to 1.5 months, until the jaw bones grow together. Sometimes doctors implant metal plates into the jaw through surgery. They are fixed with screws.
Carrying out anti-inflammatory therapy.
When the main course is completed, and the tire is removed, then it will be possible to proceed to the rehabilitation stage. It should be aimed at restoring several vital important functions: chewing, swallowing, speech, vision.
Splinting for a broken jaw
Splinting is one of the main methods of treating a jaw injury. The procedure is the fixation of fragments using a structure consisting of plastic or wire.
The type of splinting depends on the nature of the injury:
Superimposed on one side, when the fracture is one-sided, for this a wire is used that fixes the damaged areas.
Superimposed on both sides, while the design has a more rigid base. In addition to it, there are hooks and rings.
When both the upper and lower jaws are broken and there is displacement, then it is advisable to use double jaw splinting. For fixation, copper wire is used, with fastening by the teeth and fixing the jaws with rings.
If a plastic version is used, then it should be placed under the chin and fixed with a bandage around the head. But this method is indicated in the case when assistance must be provided in a short time to deliver the victim to the traumatology department.
When the fracture is complicated and there is a significant displacement of fragments, then before splinting, it is necessary to compare them.
Nutrition for a broken jaw
Correction of the diet in such injuries is a necessity. This is due to the fact that during intensive care and at the time of recovery, the jaws will be in a fixed state, which means that a person will not be able to fully control them.
Fracture of the lower jaw serious injury, which most often affects men aged 20-40 years. As a result of such injury, a partial or complete violation of the integrity of the bone occurs. Fractures of the lower jaw are diagnosed much more often than injuries of the upper.
This phenomenon is dangerous for human health, since it can provoke severe complications up to lethal outcome. To prevent undesirable consequences if signs of a fracture of this single movable skull bone are detected, you should immediately consult a doctor. In most cases, the life of the patient depends on the timely provision of assistance.
Features of the structure of the lower jaw
Lower jaw - horseshoe unpaired bone skull for chewing food. The upper parts of its middle and two ascending branches end in two processes: anterior (coronary) and posterior (condylar, or articular). The lower jaw has the following anatomical features:
- The articular process, the middle part of her body and the area of \u200b\u200bthe angle are typical places that are most often injured.
- In the region of the angle of the lower jaw is the facial artery. It has microscopic parameters, however, if it is damaged, it can begin profuse bleeding and form a hematoma.
- Branches run along the mandible trigeminal nerve responsible for the sensitivity of the mucous membranes of the cheeks and tongue. Its injury causes a partial or complete loss of the susceptibility of these organs to the effects of external factors.
- The lower jaw and the bones of the facial skeleton are connected through the temporomandibular joint, which makes it possible to chew food. Despite the apparent strength, this connection is quite easy to break.
How are fractures classified?
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A jaw fracture is classified in many ways. According to the severity of violations of the integrity of the mandibular bone are divided into open and closed. In relation to the area of injury, they are direct and indirect. Based on the line of the crack, this type of fracture is divided into single, double and multiple. The classification of mandibular injuries includes bilateral and unilateral varieties.
In addition, there are fractures of the lower jaw with displacement of bone fragments and without their displacement. The described type of injury is also classified as a fracture of the canines, incisors, coronoid processes, as well as damage in the area of the angle, which is also called an angular fracture of the lower jaw.
open and closed
An open fracture is characterized by displacement and protrusion of parts of the bone, as well as a violation of the integrity of the mucous membranes, muscles and skin. In this situation, the probability of infection of the affected tissues is high. Often, in addition to the maxillofacial surgeon, a cosmetologist is involved in the treatment. The lower jaw of this type of injury is much more likely than the upper jaw. With a closed type of fracture, only the bone is damaged, the integrity of the soft tissues is not violated.
Direct and indirect
Fractures, depending on the location of the damage in relation to the point of application of the traumatic force, are classified into direct and indirect. In the first case, injury to the bone occurs directly in specified point. Indirect damage occurs at some distance from it, in a more fragile area. Along with this, there is also a fracture mixed type, in the formation of which a combination of the first two types occurs.
Single, double and multiple
Treatment of jaw fractures
Injuries of the jaw bones are treated in the department maxillofacial surgery. Treatment methods are classified into conservative (orthopedic) and surgical (osteosynthesis). If you can do without surgery, reposition is carried out. During its conduction, the anatomical position is attached to the bone, as a result of which the jaw fuses correctly. If it is not possible to apply this method, an elastic stretcher is used.
- antibiotic therapy;
- taking vitamin D to speed up tissue repair;
- the use of anti-inflammatory drugs (Ibuprofen, Ketanov, Movalis);
- means that restore phosphorus-calcium metabolism (Calcemin, Calcium D3 Nycomed).
Indications for osteosynthesis are multi-comminuted injuries, reconstructive surgery, neoplastic process in the area of damage, as well as injury to the condylar process complicated by displacement of the articular head. During the procedure, damaged soft tissues are exposed, reposition and immobilization of bones are performed using metal structures.
Diet
Diet during the recovery phase characteristics. For a certain time in varying degrees chewing function is impaired, so you should eat only liquid food. If it is impossible to chew and swallow food, the patient is prescribed food, daily calorie content which is from 3000 to 4000 calories. In this case, food that has the consistency of liquid cream enters the body through a probe.
In cases where the patient can chew and swallow food, he is shown a diet with the same nutritional value, however, the food at the same time has the consistency of thick sour cream. After discharge from the hospital, you need to eat dairy products, meat broths, drink strained juices and compotes from fresh fruits, berries and vegetables. Food should be varied.
Recovery activities
Rehabilitation is an obligatory stage of treatment. Thanks to calcium electrophoresis, magnetotherapy and infrared radiation, the injured jaw heals much faster. These methods are especially effective for angular fracture. Helps develop the joint physiotherapy. It includes regular facial exercises and self massage facial muscles. Average duration recovery period is 1.5–2 months.
Along with this, in order to avoid infection of damaged tissues, oral hygiene should be especially carefully monitored. Rinse your mouth after every meal antiseptics. If it is impossible to fully open the mouth, you can rinse it with a straw.
