Mandibular Fracture Classification and Management (Part 1) PDF

Classification and management of Mandibular fractures – part 1 Dr. Mohammad Zahir Kota, BDS.MDS.MOMS RCPSG(UK) Outline Introduction Classification systems General classification. Anatomical classification. Relation of the fracture to the site of injury. Completeness. Direction of fr...

Classification and management of Mandibular fractures – part 1 Dr. Mohammad Zahir Kota, BDS.MDS.MOMS RCPSG(UK) Outline Introduction Classification systems General classification. Anatomical classification. Relation of the fracture to the site of injury. Completeness. Direction of fracture and favorability for the treatment. A. Management of mandibular fractures i. Mandibular fractures in children ii. Mandibular fractures in adults 1. Closed reduction indications and advantages 2. Contraindication for open reduction 3. Open reduction indications and advantages Introduction The mandible is a largest, heaviest and strongest bone of the face. Importance : Airway Facial contour Chewing , Swallowing Speech More prone to injury - prominent position Introduction Contd Anatomy of the Mandible The body - horseshoe or parabola shape. Two rami project upward - posterior aspect of the body. e The condylar processes -articulate with the temporal bone to form the TM joints. Blood supply: Central blood supply -inferior alveolar artery Peripheral blood supply -periosteum Ipo o Classification o Kruger’s General Classification: i) Simple or closed: Linear fracture not have communication with the exterior or the interior. ii) Compound or open: This fracture has communication with the external environment through skin or with the internal I environment through mucosa or periodontal membrane. Kruger’s General Classification: iii) Comminuted: A fracture in which the bone is splintered or crushed into multiple pieces. a I iv) Complicated or complex: m Fractures associated with the damage to the important vital structures complicating the treatment as well as prognosis. v) Impacted: Rarely seen in ‫ ناد ًرا ما يظهر في كسور الفك‬:‫متأثر‬ ‫ هذا هو الكسر الذي يتم فيه‬.‫السفلي‬ mandibular fractures. This is a ‫دفع جزء واحد بقوة إلى الجزء اآلخر‬ fracture in which one fragment is.‫وال يمكن مالحظة الحركة السريرية‬ firmly driven into the other fragment and clinical movement is not appreciable. Kruger’s General Classification contd vi) Greenstick: It is an incomplete fracture seen in young children III because of inherent resilience of the growing bone. vii) Pathological: Spontaneous fracture of the mandible occurring from mild injury or as a result of a normal degree of muscular if contraction. This is because of weakness caused due to the pre existing bone pathological processes. Classification contd Based on Anatomic Location I). Rowe and Killey’s classification A. Fractures not involving the basal bone—are termed as dentoalveolar fractures. B. Fractures involving the basal bone of the mandible. Subdivided into following: i. Single unilateral ii.Double unilateral iii.Bilateral iv. Multiple II). Dingman and Natvig classification by anatomic region A Symphysis fracture (midline fracture). B. Canine region fracture. C. Body of the mandible D. Angle E. Ramus region F. Coronoid region. G. Condylar fractures. H. Dentoalveolar region.  Classification contd 3. Based on Relation of the Fracture to the Site of Injury i. Direct fractures. E ii. Indirect (countrecoup) fractures. Classification contd 4. Completeness Complete and incomplete fractures. 5.According to the Direction of Fracture and Favorability for Treatment A 1. Horizontally favorable fracture. 2. Vertically favorable fracture. 3. Horizontally unfavorable fracture. 4. Vertically unfavorable fracture. Unfavorable favorable Jerry horizonty  it isnt Gand 57 Anatomic 55 Si C i Site 8 5 5 complete incomplete Sa E Discuss 5 0 MANDIBULAR FRACTURES IN CHILDREN Incidence is