Jaw Fracture Treatment Techniques

Intermaxillary Fixation

• Intermaxillary fixation is a common method used to treat jaw fractures.
• The method involves fixing the upper and lower jaws together.
• Multiple-loop wiring was a popular method during World War II.
• The decision to remove a tooth in the line of fracture is based on factors such as presence of caries, periodontal disease, and esthetics.
• Extraction of a tooth may be necessary if severe doubt exists about its viability.
• Infected and carious teeth outside the fracture line should be extracted before intermaxillary fixation.
• Elastic traction can be used to overcome distraction and muscle spasm.
• Intermaxillary wires can be used after 1 week to better manage hygiene and patient comfort.
• Antibiotics are often used as a prophylactic measure for the first week.
• Hospitalization is generally recommended for fractured jaw patients.

Condylar Fracture

• The condylar neck is a common site for fractures.
• The lateral pterygoid muscle attachment should be removed to prevent redislocation.
• The condylar fracture treatment involves open reduction with direct wiring.
• Telescoping of fragments can be addressed using figure-of-eight wiring or plate fixation.
• Removal of the lateral pterygoid muscle attachment helps prevent dislocation.
• Condylar fractures in children can impact jaw growth.
• The most critical period for condylar fractures is from 1 to 5 years of age.
• Reconstructed rami following closed treatment of condylar fractures occur in accordance with Wolff's law.
• Fracture-dislocation in children less than 2.5 years old poses a particularly challenging situation.

Fractured Jaws in Children

• Deciduous teeth present challenges for wiring due to their bell-shaped form.
• Acrylic splints are an alternative to wiring for deciduous teeth, although they require fabrication time.
• Fine wires (28-gauge) facilitate wiring of deciduous teeth.
• Malpositioned angle fractures in children are treated by open reduction.
• Condyle fractures in children are usually treated conservatively.

Feeding Problems

• A high-protein, high-calorie, and high-vitamin diet is essential for patients with fractured jaws.
• Liquid or semi-liquid foods are preferred.
• Examples of suitable foods include:
  • Fruit juices
  • Cereals (thinned with milk)
  • Strained fruits
  • Strained meat
  • Strained vegetables
  • Cream soup

Maxillary Fractures

• Maxillary fractures are serious injuries due to the proximity of vital structures.
• Common causes include automobile accidents, blows, industrial accidents, and falls.
• The type and extent of the fracture are determined by the force, direction, and location of the impact.
• Horizontal maxillary fractures (Le Fort I) involve separation of the maxilla from the skull above the palate and below the zygomatic process.
• Horizontal fractures can result in a "floating jaw."
• Displacement of the maxillary fracture can occur due to muscular pull or the force of impact.
• The diagnosis can be missed if the fracture is not displaced.
• Assessment involves examining the teeth, lips, and cheeks for signs of trauma.
• Movement in the fractured jaw can be detected by applying pressure to the teeth.

This quiz covers essential methods for treating jaw fractures, focusing on intermaxillary fixation and its application. Participants will learn about the procedures, indications for tooth extraction, and post-operative care necessary for effective healing. Ideal for dental students and healthcare professionals.