Fractures of the jaw: treatment. Classification of jaw fractures. What is dangerous is a fracture with an offset

Fractures of the jaw in medical practice are quite common. Doctors say that the jawbone damage is the seventh part of the total number of fractures.

In order to recognize the problem in time and take the necessary measures, it is necessary to understand the existing types of trauma and their symptoms.

What is the jaw fracture?

Fractures of the jaw represent damage to the jawbone in any place, accompanied by a violation of the integrity of surrounding tissues. At the same time, muscles, facial nerves, and vessels can be affected.

The causes of this kind of injuries are different, but most often they are caused by a mechanical impact: a blow, a fall, an accident. In addition, there is also a pathological fracture that occurs as a result of external action on the jawbone in the presence of chronic diseases such as syphilis of bone, osteomyelitis, tumors. Thus, in severe osteomyelitis, parts of the bone die, which leads to its spontaneous fracture.

How to recognize a jaw fracture

There are several signs on which it is possible to assume the presence of a jaw fracture:

1. When injured, a person feels severe pain.
2. When you try to open or close your mouth, the pain sensations increase, you may hear a click.
3. The jaw can move to the side.
4. With an open fracture, there is a rupture of the facial tissues over the jawbone.
5. In the case when the nerve endings are affected, there is some numbness during the touch to the face.
6. Headache, dizziness.

Symptoms may differ, it all depends on which part of the bone is damaged.

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

Fracture of the jaw is often accompanied by damage to the brain or cervical spine. To exclude such complications, an additional analysis is carried out.

Types of jaw fractures

Fractures of the jaw have an extensive classification in several directions:

1. Separation by etiological or causative factor:

• The emergence of a jaw fracture as a result of trauma;
• Fracture of the jaw as a result of pathology of tissues and bone.

2. Depending on the fracture line:

• Longitudinal;
• Direct;
• Obliques;
• Zigzag-shaped;
• Oscholotye;
• Transverse.

3. By number of debris:

• Multiple;
• Single;
• Double;
• Triple.

4. Depending on the location of the fracture:

• Fracture of the lower jaw;
• Fracture of the upper jaw.

5. The degree of violation of the jawbone:

• Complete;
• Incomplete (cracks, fractures).

6. Depending on the degree of soft tissue involvement:

• Closed fractures - soft tissues are not affected;
• Open - the integrity of soft tissues is broken.

In addition, jaw fractures are:

• With defects and without defects;
• Combined.

Treatment of a fracture of the lower jaw

The main symptoms for fractures of the lower jaw are:

• pain;
• Impossibility of chewing food because of pain syndrome;
• Possible numbness of the chin, lips;
• Malocclusion;
• nausea;
• dizziness.

In the process of diagnosis, the doctor, in the first place, determines the overall physical condition of the patient. For this, the pulse and pressure are measured. After this, tomography is performed to exclude traumatic brain injury.

During external examination, painful points, defects, hematomas are determined. A test is performed in which the alleged fracture site is identified. After that, an X-ray examination is performed.

In the corners, the lower jaw has a very thin structure and even with a slight impact or other lateral damage, a fracture is possible.

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

Therapy

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

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

The most frequent places of fracture of the lower jaw are:

• The projection of the mental opening;
• Middle of jaw;
• Joint appendix;
• Corners of the jaw.

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

The bones of the lower jaw can be fixed with a nylon vein or wire. At the same time, anti-inflammatory therapy is performed, vitamins and agents are prescribed to strengthen immunity.

Fracture of upper jaw

The upper jaw is a paired bone, it is located in the center of the face and participates in the formation of the cavity of the nose, mouth, orbit. Fracture of the upper jaw is very dangerous. First, the skull can be touched. Secondly, there is a risk of concussion or the development of a disease such as meningitis.

In addition to the standard symptoms, fractures of the upper jaw can be accompanied by hemorrhage, hematomas in the eye area, impaired vision, loss of consciousness. Respiratory and masticatory functions are difficult. If a person can not breathe, airways and the mouth should be freed from interfering foreign bodies.

With this injury, bleeding may occur. To stop it, you should put a tampon or a pressure bandage.

Complicated with jaw fracture

Complicated is a jaw fracture with an offset, in which there is a violation of the normal location of bone fragments. May be complete and incomplete.

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

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

Fracture of the lower jaw with a displacement initially requires combining the fragments, removing the edema, after which a rigid fixation is necessary.

In the case of a fracture of the upper jaw , it is often necessary to stretch it. To do this, use a special orthopedic device, which gradually returns the damaged bone to the correct position.

Such injuries are very dangerous, since they can provoke asphyxia, which can lead to death if untimely assistance is provided. To prevent suffocation, it is necessary to clean the oral cavity of foreign bodies, blood, and then put the person in a horizontal position, face down, laying under the chest a rolled blanket or clothes.

Splint at the fracture of the jaw

The main method of treating jaw fractures is splinting - fixing fragments with a special design of wire or plastic.

There are the following types of splinting:

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

The tire with a jaw fracture can also be plastic. It is placed under the chin, runs along the cheeks and is fixed with a bandage around the head. But this method, as a rule, is resorted to in the event that urgent shinirovanie (for example, at transportation of the patient in medical institution) is required.

If a person has a broken jaw, splinting is performed strictly after combining the fragments. Additional external fixation devices may also be required.

Possible complications

Possible complications in fractures of the upper and lower jaws are:

• Sinusitis;
• osteomyelitis;
• Improper fusion of fragments;
• Joint is false.

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

Osteomyelitis - a frequent complication in fracture of the lower jaw. It is a purulent formation that affects the bone. In order to prevent the development of this pathology, antimicrobials, physiotherapy, and vitamins are prescribed.

Incorrectly fused jaw fracture can occur in the following cases:

• The patient late turned to a medical institution;
• The treatment regime was disrupted;
• When there was a fracture of the jaw, the splinting was carried out according to the incorrectly chosen method.

To correct a situation it is possible surgically (more often and do) or by means of the exhaust system.

The joint false can occur with osteomyelitis, is a violation of the jawbone with mobility in some departments. Treatment is only prompt.

Rehabilitation

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

1. Fixation of fragments. The tire is used for fracture of the jaw and some other types of fixing apparatus.
2. Anti-inflammatory therapy. Includes the reception of antibiotics, antifungal and restorative drugs.
3. Correct oral hygiene. Carried out by both the doctor and the patient. It consists in cleaning the tire, teeth from food residues, treatment of the oral cavity with special antimicrobial agents. Every day you should rinse with a solution of soda, and after meals use antiseptics.
4. Physiotherapy is a special gymnastics aimed at restoring the functions of the jaw. Exercise should start from the first day of the injury to prevent the formation of scars and to avoid such complications as improperly fused jaw fracture.

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

If the child is hurt ...

According to statistics, this kind of damage is observed in boys aged 6 to 14 years, that is, during a period of increased motor activity, then the number of accidents goes down. In girls, such a relationship, the incidence of fractures from age is not noted. In any case, this injury is very unpleasant, but the worst is that it is mainly accompanied by craniocerebral injuries, a violation of the integrity of other bones and soft tissues. It is strictly not recommended to engage in self-activity. At the slightest suspicion of a fracture, you should immediately seek professional help.

When you visit a doctor, a medical history is drawn up. It is not always possible to diagnose a jaw fracture visually, therefore the specialist necessarily prescribes an x-ray study. Based on its results, a treatment regimen is prepared. The process of rehabilitation is not much different from the one described above.

Nutrition rules

Due to the fact that in the process of therapy and rehabilitation the jaws are in a fixed position, it is necessary to adjust the diet accordingly. Bone fuses within a month (at least), and all this time should only eat liquid food.

Fractures of the jaws mean eating a meal that is not thicker than sour cream by its consistency. An approximate menu can consist of soups with grinded vegetables, fruit purees, dairy products, broths, various cereals. After removing the tire, you need to start taking solid food gradually, so as not to provoke digestive disorders.

Breakfast can consist of a glass of yogurt, liquid oatmeal, apple puree.

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

As snacks you can use sour-milk products. For dinner, you should prefer a thin potato soup, puree of fruit.