How the jaw grows. Treatment of a mandibular fracture. How long does a broken jaw heal

- 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 area of ​​​​the angle mandible, 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:

Complete fracture is considered in the case when there was a displacement of fragments, jaws. 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 and the soft tissues of the face are also damaged.

With a 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. With an open injury, blood enters the oral cavity more often than into the external environment. The more blood loss, the 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.

If severe pain occurs, it is necessary to alleviate 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. Used to diagnose a fracture x-ray examination. Since this is a serious injury, often accompanied by a spinal injury, an additional x-ray of it is often prescribed before starting treatment. cervical. 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 upper jaw, depending on its type:

If there was a fracture under the palatine vault, with a break 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 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 both under local and under 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:

middle part jaw pointing down.

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 of the jaw 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 by surgical intervention metal plates are implanted in the jaw. 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.

Jaw fracture - very dangerous injury, resulting in not only pain, but also unpleasant complications work-related different parts body and internal organs starting from the oral cavity and ending nervous system. Everyone is subject to such an injury, but most often it occurs in men 25-45 years old. This happens due to falls and bumps, as well as due to clinical anatomy lower jaw (protruding chin) and a special structure of bones. Gunshot wounds also occur (due to improper handling of weapons, during an attack), but non-gunshot injuries are more common.

Symptoms of a fracture of the upper or lower jaw with a photo

Such an injury is accompanied by the following symptoms:

Classification of fractures of the upper jaw

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Injuries of the upper jaw are classified according to the level of the fracture and its nature. In the latter variant, fractures with displaced fragments and without displacement are distinguished. By level (place) they are:

• Fracture Le Fort I - on the lower level. With a bilateral fracture, it is accompanied by breaking off the bottom maxillary sinus and a broken base of the nasal septum.
• Fracture Le Fort II - according to the average level. Often accompanied by separation of the upper jaw and nasal bones from the skull.
• Fracture Le Fort III - after top level. It is accompanied by a complete separation of the upper jaw, nasal bones and cheekbones from the skull, as well as a traumatic brain injury.

Injuries are also distinguished by their nature:

• traumatic - as a result of external influence;
• pathological - as a consequence of diseases (tuberculosis, osteomyelitis, syphilis, etc.).

There can be complete and incomplete fractures:

• with complete interruption of the injured bone;
• incomplete - expressed by cracks, breaks.

Fractures can be open or closed. Injuries of the upper jaw are rarely closed, because. rupture of the oral mucosa occurs. Fractures are also classified according to the number of injuries: single, double, multiple.

Types of mandibular fractures

Mandibular fractures are complete and incomplete, open and closed, single, double and multiple. Clinical picture shows that most often injuries occur in the area of ​​the angles (angular fracture), articular and condylar process. Fracture of the lower jaw is represented by the following classification:

• according to the type of fracture: linear, finely splintered, large-splintered, with and without displacement;
• depending on the consequences: deprivation of a tooth, finding an incisor in the moon;
• at the location of the injury: the branch, the base of the condylar process, the injury in the region of the coronoid process were injured;
• in the direction of impact: oblique, zigzag, transverse and longitudinal.

First aid

In case of a fracture, before examining a doctor, the following steps should be performed:

After all these activities, you should immediately consult a doctor. The presence of a damaged jaw is very dangerous and can cause serious complications. The very best and safe option an ambulance will be called. Usually people with such injuries are placed in the maxillofacial unit.

Diagnostic methods

Determine the presence of a fracture obvious signs and understand what to do next, the doctor will be helped by the patient's complaints and symptoms, but for staging accurate diagnosis and determining the complexity of the fracture, it is necessary to use the following methods:

• initial examination and palpation;
• x-ray;
• CT scan;
• orthopantomography;
• mastication;
• gnathodynamometry;
• myography;
• thermovisiography;
• rheography;

x-ray

Radiodiagnosis is compulsory procedure, which reliably shows the presence of a fracture, its complexity, pathology, whether there are fragments and problems with the roots of the teeth. No additional X-ray preparation is required. However, it should be abandoned by pregnant women, patients with bleeding and people in serious condition.

Usually take several pictures in frontal, lateral and axial projection:

• In direct projection, the picture shows, as a rule, the general condition of the jaw. It is done lying on the stomach on the front side.
• Lateral X-ray is used as an addition to the first. On it you can see large defects and the condition of the teeth. The patient is placed on the desired side and a cassette is applied to the cheek.
• Axial projection shows through bilateral fractures of the lower jaw, as well as defects in trauma of the articular and condylar process of the lower jaw. The patient is placed on the stomach and the chin is pulled out.

Inspection and palpation

Inspection and palpation is another way to diagnose. Thanks to them, the doctor will be able to get the first information about the fracture. They are carried out at the same time when the patient is interviewed. Palpation should only be carried out by a qualified medical worker. Otherwise, you can apply more harm and worsen the patient's condition.

During the examination, swelling of the face at the fracture site is immediately visible. If the skin in the area of ​​swelling is red or pink color, there were complications in the form inflammatory infiltrate. Blue colour skin indicates bleeding subcutaneous tissues. Fractures may be accompanied by blueness of the neck, chest, abdomen.

The asymmetry of the face also signals an injury during examination. Hemorrhage in the eyes may indicate a fracture of the base of the skull. This is also indicated by the release of liquor ( cerebrospinal fluid) from the nose. It is often confused with ordinary bleeding, but it is more dangerous and can lead to inflammatory processes in the brain and a significant weakening of the body. How badly a person is affected depends on their anatomy.

Only at the end of the examination, the doctor proceeds to palpation. Be sure to check the sensitivity of the skin of the nose and lips to find out if the infraorbital nerve is damaged. When there is a suspicion of a fracture of the lower jaw (condylar process), its base and the posterior edge of the branch are felt. These are the narrowest parts of it. If it is impossible to palpate at least one head, we can talk about an injury to the condylar and articular process. To determine the location of the injury to the upper jaw, the doctor presses on the wisdom teeth or last molars.

Treatment Methods

Fractures can only be treated in a hospital. Staples and plates are used to restore the bone. Antibiotics and physiotherapy are prescribed. In the most severe cases surgery is possible (for example, with a fracture of the articular process of the lower jaw). The main treatment is carried out with splinting and shunting, or, in other words, splinting.

Various types of splinting

Splinting is the most commonly used treatment method. In this case, the broken place is fixed with a special construction made of plastic or wire. Plastic retainer is used if necessary. emergency assistance the victim and for its transportation (for example, in case of a fracture of the condylar process of the lower jaw). Additionally, a bandage is applied. The type of wire splint depends on how much the broken jaw has suffered:

In some cases, fixation can be carried out with a bandage. Before splinting the jaw, bone fragments must be carefully aligned. They put the tire usually for 1 month.

Tigerstedt splint

Serious injuries are treated with a special Tigerstedt splint. It is an aluminum construction with hook loops and rubber intermaxillary traction. If the rubber band bursts, then you need to re-install the tire. Self-removal of the superimposed tire is strictly prohibited.

What can you eat during treatment?

During the healing of the bone, certain nutritional difficulties arise. The patient cannot chew as before, so the food must be liquid and at the same time fully cover the need for vitamins and minerals.

• baby formulas and cereals;
• puree from vegetables and fruits;
• broths, mashed soups;
• milk, kefir, fermented baked milk, yogurt;
• porridge with milk;
• grated meat diluted in milk or broth.

After removing the splint, it is necessary to start eating solid food gradually. This will not only allow you to gradually develop the chewing function, but also prepare the stomach for normal nutrition, and prevent disturbances in its work.

How long does a fracture take to heal?

The healing of a broken bone can take approximately 21-28 days. How long the bone heals depends on individual characteristics(anatomy) of the patient's body.

On the 28-30th day after the X-ray of the broken jaw, if everything is fine, the splint is removed. However, do not rejoice ahead of time. Ahead is still waiting for a course of rehabilitation and restoration of all functions.

Rehabilitation and the consequences of a fracture

With jaw injuries, the following complications and consequences may occur:

• Osteonecrosis is the death of a fractured bone, especially when the condylar process of the mandible is injured. With its possible development, an operation is indicated.
• Violation of chewing functions - after a long period of inactivity, the jaws open and close heavily (we recommend reading:). Mechanotherapy helps speedy recovery.
• Change in bite due to improper fusion of fragments. As a result, pain may occur during jaw movements. This is due to early removal of the tire and poor immobilization.

Also, asymmetry of the head and a change in facial features, loss of teeth in the future, the appearance of cracks between the teeth may also appear. Psychological discomfort causes a crunch of the fused jaw. In order to avoid all these consequences, you should consult a doctor in time for timely and qualified treatment.

As a rehabilitation, physiotherapy exercises, enhanced oral hygiene, physiotherapy (massage, electrophoresis, etc.) are recommended. Begins active phase rehabilitation a month after everything heals. You can learn more about first aid for a broken jaw and the splinting process on the video.

Dislocation and fracture of the lower jaw are serious injuries 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 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 take an x-ray of 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, 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

You can diagnose the presence of a dislocation of the jaw using x-rays, as well as a visual examination of the patient. Anterior dislocation can be reduced in several ways:

1. 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.

1. 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.

1. 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.

1. Popescu Method

This method is used in extreme cases, when no methods help, or a person has old dislocation. Reduction takes place under local or general anesthesia, depending on the complexity 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 does not help, an 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:

1. Blockade of chewing muscles.
2. Massage.
3. Medical therapy.
4. Normalization of interalveolar height.
5. Prosthetics of missing teeth.
6. Physical exercises.
7. 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:

1. 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.

1. incomplete fracture

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

1. Open fracture

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

1. 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:

1. 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.

1. Antishock therapy.
2. Stop bleeding.
3. 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.

A fracture is a displacement of bones from their physiological position. As for the jaw, there are fractures of the lower and upper jaws, which we will consider separately.

Fracture of the lower jaw and

Description of injury

Such a fracture is characterized by a complete or partial displacement of the jaw bones from their anatomically correct position. It often occurs due to mechanical damage jaws during sports, in an accident, in a fight and during gunshot wound. Depending on the nature of the damage, the following types of mandibular fractures are distinguished:

• a complete fracture, when, in addition to displacement of the bone, a shift of the fragments also occurs;
• incomplete fracture - when the main bone is displaced, the fragments do not change their position;
• open fracture - when the bones are displaced, a rupture of the oral and sometimes nasal cavity occurs;
• closed fracture, which is almost impossible to detect when visual inspection because it is hidden in the thickness of the tissues.

Mandibular fracture symptoms

In some cases, it is very difficult to determine that a patient does have a fracture. A broken jaw may not show any obvious signs of trauma, and displacement of the bones can only be seen on x-ray. In general, based on symptoms such as acute or Blunt pain in the area of ​​the cheekbones or chin, malaise, headache and dizziness, a traumatologist can make a correct diagnosis.

Broken jaw: treatment

Combination of bone fragments (if necessary);

Tire overlay;

Fixation of both the lower and upper jaw for the entire period of bone fusion;

Taking antibiotics and antispasmodics.

Broken jaw: consequences

Depending on the nature of the damage, there may be the following consequences: displacement of the dentition, the development of malocclusion, regular displacement of bone fragments with any load on them, impaired respiratory, swallowing and chewing functions, as well as speech. Possible sinking into the throat of the tongue, lack of sensitivity of the lower jaw, as well as pain in the area of ​​the fracture. Unfortunately, despite all attempts at recovery, a broken jaw will never look the same again.

Fracture of the upper jaw

It is considered a very dangerous injury, since it cannot be avoided without a concussion and displacement of the nasal bones. Such fractures are often obtained in an accident or when fired from a firearm.

When the upper jaw is fractured, the following symptoms are observed:

Severe pain in the area of ​​injury;

Sensation of displacement of the bones due to difficulty or total absence breathing;

Violation of the respiratory, chewing and swallowing functions, as well as speech;

Hemorrhage in the eyeballs;

General malaise, weakness.

Jaw fracture treatment

Treatment of a fracture of the upper jaw must necessarily take place under the strict supervision of a doctor in order to avoid improper bone fusion and re-displacement of fragments. It mainly includes the following activities:

Treatment of injury, its mandatory disinfection;

Alignment of the septa of the nasal cavity;

The combination of broken bones, as well as their fragments;

Strong fixation of the fracture with splints to create complete immobility of the entire jaw;

anti-inflammatory therapy.

After the patient undergoes a mandatory course of treatment, he additionally needs to undergo rehabilitation in order to restore completely or partially lost functions (speech, swallowing, chewing, vision). The upper broken jaw can be fully restored.

The lower jaw is the only movable bone in the head. It is unpaired and is located at an angle to the base of the skull and upper jaw. This determines the increased tendency of this bone to fracture.

And the muscles that are attached to it, providing mobility, also provide serious displacement of fragments during a fracture. The mandible accounts for almost 70% of skeletal trauma.

Therapy Methods

The way to neutralize the consequences of an injury will depend on the accompanying factors:

1. Fracture type. Open fractures associated with bone crushing and / or affecting other organs require unambiguous hospitalization and splinting.
2. The possibility of immediate transportation of the patient to a medical facility.
3. General condition of the victim.
4. Possibility of treatment in a polyclinic. In some cases, it is necessary to send to a hospital (hospital), because there are no drugs or instruments on site, the doctor is not sufficiently qualified.

The choice of method should be based on the needs of the patient, taking into account the minimum consequences for his health and shortening the rehabilitation period.

We offer you to watch a short video that briefly describes the types of fracture and the features of treatment:

First aid

The most important thing in case of a fracture of the lower jaw is to fix it in a fixed position until the doctor arrives.

For this, a bandage is used, which passes under the chin and is tied on the crown of the head, if possible, it makes sense to fix it additionally horizontally, on the forehead. AT last resort, a motorcyclist helmet, helmet or even a hat with earflaps will do.

If a person has difficulty breathing, it is important to remove from his mouth before fixation foreign objects . The tongue must be removed from the mouth. In extreme cases, it can be pierced with a sterilized pin to prevent it from falling into the airways.

If the victim is in a state of shock, he must constantly maintain a sitting or standing position.

Orthopedic (conservative) therapy

This type of treatment is splinting or prostheses. Splinting can be dental, gingival or mixed. Depending on the material, prostheses are divided into metal and plastic.

Tires began to be manufactured at the beginning of the last century. Since then, their design has undergone many changes. But all tires, from the very first created by Tigerstedt, ending with modern models custom-made have negative consequences.

Popular types of tires are:

• Vasiliev standard tape bus with hook loops, fixed with bronze-aluminum wire. It is made of stainless steel, has parameters of 0.26-0.28 mm. Included in first aid kits. The surgeon attaches desired shape tires by hand;
• Urazalin plastic splint. It looks like an arc with a cross section in the form of an ellipse, the hooks are located along the lower edge of the base, around it on three sides there are through channels for threading the fixing thread.

  It is put on the teeth from the outside and fixed on at least three teeth, fixed with rubber rings on the hooks;

• universal bent wire tire Tigerstedt. Made from aluminium, bent by hand.

  There are 5 types: a single-jaw smooth connecting splint-clip, a single-jaw binder with a spacer bend, with hook loops for intermaxillary fixation, a single-jaw with an inclined plane, a single-jaw with a supporting plane;

• single jaw compression-distraction tire Sagandykov.

The main disadvantages of this method of treatment can be called:

1. Injuries of the mucous membrane of the lips.
2. Difficulties in oral hygiene.
3. Leukoplakia (erosion) of the mucosa as a result of the occurrence of galvanic currents (applies to all metal tires).
4. The possibility of an allergy.
5. Injuries to the teeth (dislocations, fractures), malocclusion, which, even after rehabilitation, can be permanent.

For this reason, modern dentists and surgeons tend to consider splinting only as a temporary measure of bone fixation, preferring it in most cases.

Surgery (osteosynthesis)

Indications for surgical intervention are:

1. Absence of teeth or their mobility.
2. Soft tissue damage.
3. Multiple fractures.

Tires, pins, knitting needles and wires of a special design are used to fuse the bone and fix the fragments. It is also possible to apply a special adhesive to the bone, which allows more complete alignment of the surfaces and accelerates healing.

The main disadvantage of osteosynthesis is high risk complications(according to the data of Russian scientists presented for 1997 - 27%). Most often, this is an infection of the oral cavity or corrosion of the metals used to connect the bones.

Modern technologies and high professionalism of specialists make it possible to reduce the likelihood of such an outcome, it can be hoped that over time it will be minimized.

The essence of the orthopedic process in a hospital

When you get to the hospital with a fracture of the lower jaw, the first thing you need to insist on is anesthesia. Not all surgeons believe that it is necessary. The patient's task this case provide information about drugs to which allergies are possible, and adequately assess your pain threshold.

Even an operation that is insignificant and quick at first glance can be delayed if new damage is discovered that was previously invisible.

After an X-ray, which allows you to assess the fracture and plan a method of treatment, all teeth located at the site of injury should be removed. During the operation, the patient is conscious(general anesthesia is rarely used).

Pain and shock are rare, but you need to prepare for unusual sensations, the sight of a scalpel, blood.

The cost of splinting is from 20,000 rubles, when contacting public hospital the procedure is carried out under the policy of compulsory medical insurance.

Tooth splints

Photo: tooth splint: a - in the manufacturing process; b - completely finished

Used when there are at least three healthy teeth . The tire in this case is a wire with which the jawbone is attached to the bases of the teeth. If there are not enough of them at the fracture site or there is a displacement of debris, an additional spacer is installed.

Splints may affect one or both sides of the jaw. In the second case, a more massive structure and rigid wire are used.

In case of a fracture in the area of ​​the dentition or a fracture of both the upper and lower jaws, the use of a two-jaw splint is necessary. For even teeth, loops or hooks are attached to which the tires are fixed.

The loops of the upper and lower jaws are connected by rubber rings. This design limits mobility, food is possible only through a tube.

The following video shows this procedure in detail:

Dental and gingival splints

Such designs are used in the absence of healthy teeth, on which a splint can be fixed. Most often, a monolithic plastic plate is used, in which a hole is made for receiving liquid food. For minor fractures, use removable dentures patient.

If the patient's teeth are loose, the tire is attached to the holes in the bone, which are drilled in the alveolar part. This avoids removal and achieves immobilization (immobility) of parts of the jaw.

Stages of osteosynthesis

The operation is carried out under mandatory local anesthesia. Before it is carried out for 6 hours, you must refrain from eating. The operation consists of the following steps:

Sometimes with a lack bone tissue or late diagnosis of a fracture may require the use of tissues from other bones in the body.

So in the Dental Journal (2004) a case was described when a twenty-year-old patient, after applying a splint after the expiration of the prescribed period, had no positive dynamics and suppuration began. The problem was successfully solved after surgery using tissue ilium(pelvic area) and a course of antibiotics.

AT recent times practice includes the so-called stable osteosynthesis. It allows you to fix the bones with minimal surgical intervention. Such osteosynthesis takes place without incision of the periosteum.

The method is suitable for limited quantity fractures, but has already shown its effectiveness and a high degree of adaptation of the devices used.

The cost of standard osteosynthesis in private clinics starts from 25,000 rubles. In complex operations, an unusual structure of the jaw, it may be necessary to individually manufacture a connecting structure. In this case, the price will be correspondingly higher.

Features of therapy of the articular head (process)

Photo: bilateral fracture of the lower jaw in the area of ​​the articular processes

These fractures are usually an indication for surgical intervention, especially if they are accompanied by a dislocation of the head. The connection of bone fragments can occur by removing them from the wound and then fixing them as part of a complex implant.

Another way - fusion with a sharp needle. This method has quite a few contraindications and is used only with a massive jaw. Otherwise, the head may split.

The alternative is hardware way treatment. It is reduced to external fixation of bone fragments. A system of hook-clamps, rods and screws is used. It is attached to the patient's head.

An incision is made in the area of ​​the fracture, and the bone is fixed with hooks. soft tissues sewn in layers. The time of wearing the device can reach up to 1.5-2 months.

Therapy at home

Independently it is worth resorting only to providing the first medical care. If it is impossible to deliver the victim to the hospital, it is worth taking care of fixing the lower jaw, stopping the blood when open wound, disinfection.

If signs of infection (fever, fever, swelling) are observed, antibiotics may be taken a wide range actions. In addition to applying a fixing bandage, it is worth limiting the mobility of the lower jaw as much as possible: do not talk, do not chew (eat liquid food) before visiting a doctor.

A fracture of the lower jaw is well curable with competent and timely consultation of a specialist.. A modern arsenal of tools allows you to maintain an attractive appearance after rehabilitation, as well as to achieve a full restoration of lost functions.

Rehabilitation

The recovery time depends on general condition the patient's body. Average the tire is superimposed for a period of one and a half to two months.

Pain is present throughout the treatment, this is normal. The process of removing the tire is also painful.

In order not to harm the fusion of bones, you need to follow the instructions of the doctor. Special Issues in patients occur with food intake and oral hygiene, tk. jaw fixed.

How to eat properly

Chewing actions are prohibited, even when eating mushy soft food. Patients with a splint on the jaw eat as follows:

• Only dishes of the consistency of liquid sour cream are allowed so that they can be swallowed immediately. A tube is inserted into the mouth and the patient takes food with suction movements.
• If possible, food should not get on the teeth, because. their cleaning is impossible, and the decay of liquid nutrition residues will lead to the development pathogenic microflora, which is dangerous, especially with an open fracture.
• The food should not contain seeds and other impurities. For example, such are formed during the preparation milkshake from kiwi or strawberries.

  There is a possibility of choking, which will lead, firstly, to the impossibility of coughing and removing a foreign body with high quality, and secondly, to physical impact when coughing on fused bones and disruption of the process, an increase in the rehabilitation period and complications.

• It is recommended to consume dairy products daily, rich in calcium, which is necessary to improve the process of bone fusion.

Recovery after a fracture

To recover after removing the tire, physiotherapy is prescribed: magnet, UVI, UHF.

• Magnet. The device acts on the affected area magnetic field low frequency, which penetrates into the depth of tissues up to 5 cm. The procedure is necessary to prevent the development of inflammation and to accelerate tissue regeneration.
• UFO(ultraviolet radiation). Improves blood flow in problem area and cellular metabolism.
• UHF. The impact on the diseased area of ​​​​the electromagnetic field makes leukocytes active, which helps to increase local immunity.

Therapeutic gymnastics plays a special role in restoring health.

For 2 months without jaw movement, chewing and swallowing muscles weaken, well-chosen physical exercises help restore their normal functioning.

In addition, lung function worsens, to prevent unwanted concomitant diseases, it is required to introduce gradually normal rhythm breathing.

Some examples of exercises:

• Raise your hands up. Do not open teeth. Inhale through your mouth. Give up.
• Hands on the belt. Turning the head to the left, accompanied by inhalation through the left corner of the mouth. A similar turn to the right.
• Close eyes. Fold your lips into a tube. Tighten your mouth muscles. Make an exhalation through the mouth.

Important! Gymnastics prescribed by the attending physician! Making an approximate complex can be dangerous or useless.

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• Svetlana

  December 5, 2015 at 2:37 am

  Three years ago I had a fracture of the angle of the lower jaw. It took 8 months to fully recover, which required 2 surgeries. The first - immediately after the fracture, they installed me titanium plate and tire. The splint was removed after a month and the plate was removed after 7.5 months. And it was again an operation under general anesthesia. During this period of time, I lost 11 kilograms. I still remember everything that happened, like some kind of nightmare.

• Elena

  March 12, 2016 at 09:25 pm

  A friend broke his jaw. Or rather, they broke it. I decided to save on treatment and turned to qualified specialists. As a result, the bone has grown together with a displacement, some kind of nerve is involved, this causes a headache, and the most harmless thing is malocclusion. So in this case it is better to trust your health to professionals.

• Andrew

  September 8, 2016 at 07:21 pm

  As a traumatologist, sometimes patients are brought to me, whose concomitant injury is a fracture of the lower jaw. Especially often this happens in the case of a direct impact in this area.
  In such cases, we perform primary surgical treatment of the wound, temporary immobilization of the jaw and stop the bleeding, if any. And then we refer to maxillofacial surgeons, since only they can treat these fractures with high quality and correctly. Jaw fracture is enough serious injury, especially considering the important vessels and nerves that pass here. Therefore, I would advise you to immediately contact narrowly focused specialists who know exactly how best to help you.

• inna

  March 16, 2017 at 09:11 pm

  hello
  8 years ago, she broke her jaw, a unilateral fracture on the left below the temple. I don’t remember the details already .. they put a titanium plate, everything is fine, but now I somehow slept wrong, and I feel it bothers me. what in general there can be consequences except for a bite? And what, does it need to be removed? no one told me in the hospital

• Nicholas

  December 11, 2017 at 08:42 pm

  Plates are not installed for everyone and in some cases they are not needed. He broke his jaw: a bilateral fracture with displacement. I didn’t do the operation, and I refused the plates that are offered for crazy money. The bones healed on their own.

• Evgenia

  December 13, 2017 at 3:01 am

  The power supply with the tire installed is just awful. You can only liquid, everything has to be ground on a blender. One blender has already broken, I had to order a new one, no longer submersible, but stationary, it grinds better, I advise those who have the same problem. I have been walking with a splint for 2 months, now almost 30 days have passed, I have lost 9 kg! And I want to eat all the time, all the time! I dream to eat normal food. And yet ... to talk, because this is impossible to do.

• Masha

  December 13, 2017 at 06:58 pm

  Of the problems that fall on a person who has a broken jaw, in addition to difficulties with nutrition and dental care, there is another one - pain. They did splinting 10 days ago, and all this time on painkillers. It is impossible to sleep, every night I dissolve the tablet in milk. And I don’t know how I can stand it with a tire for another 30 days.