China
Africa
Explore chapters and articles related to this topic
Maxillofacial Trauma
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
Bleeding inside the mouth is often inaccessible to direct pressure, other than biting on a swab. If the general condition of the casualty permits, he or she should be sat up to reduce venous bleeding and to allow blood to escape through the mouth rather than falling to the back of the throat and compromising the airway. Bleeding from the inferior alveolar artery within the mandible is usually controlled by reduction of the mandibular fracture and immobilization. It may be helpful to pass a wire around the teeth on either side of a bleeding mandibular fracture (bridle wire), tightening it to pull the ends of the fracture together; in this case, maxillofacial assistance will be required. Torrential bleeding from the region of the nasopharynx following trauma to the middle third of the facial skeleton is difficult to manage and often signifies a fracture of the skull base. Massive resuscitation may be required.
Surgical Emergencies
Published in Anthony FT Brown, Michael D Cadogan, Emergency Medicine, 2020
Anthony FT Brown, Michael D Cadogan
MouthExamine for broken or missing teeth. They may have been inhaled (see p. 374).Check for dental malocclusion, suggesting maxillary or mandibular fracture (see p. 375).Assess for nasopharyngeal bleeding, which may be profuse and associated with a basal skull fracture. Look for any tongue lacerations, although they rarely need repairing (see p. 374).
Head and neck
Published in Tor Wo Chiu, Stone’s Plastic Surgery Facts, 2018
Airway or bleeding issues aside, most cases of mandibular fracture are not urgent. Whilst it was often thought that fractures should be fixed somewhat urgently, e.g. within 12 hours (Champy) or at least within a few days, a literature review by Ellis (Oral Maxillofac Clin North Am, 2009) found no evidence to suggest that delay increases complications. Operating early (<48 hours) may reduce the infection rate, but otherwise there is little difference when delayed for 1–2 weeks, though fractures in the young heal quicker.
An approach for simultaneous reduction and fixation of mandibular fractures
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2023
Ethan Snyder, Mohamed Trabia, Nir Trabelsi
There are four primary muscles attached to the mandible that aid in mastication: masseter, temporalis, medial pterygoid, and lateral pterygoid (Shayesteh Moghaddam et al. 2018) and (Lovald et al. 2010). Each of these muscles induce forces of varying magnitude and direction during speaking or eating. After a mandibular fracture, these muscles tend to either separate or reduce the fracture, depending on the fracture location and the direction of the muscle forces proximal to the fracture. Muscle forces corresponding to a right molar clench are listed in Table 1 (Korioth et al. 1992). These forces were scaled down to 60% of their original values to more accurately portray post-surgical loading (Tate et al. 1994). Each muscle group was associated with unit vector directions and a scale factor, depending on which side of the mandible the clench force was applied to. The locations of muscle forces and fixed supports were chosen based on (Korioth et al. 1992). While the muscle origins were symmetric on both sides of the mandible, the force vectors for the left side are asymmetrical across the YZ-plane, which is the mandible’s vertical plane of symmetry. Figure 9 presents a view of muscle force origins. These muscles are labeled A through E. Post-surgical muscle forces were used in the simulations.
Violence-related traumatic brain injury
Published in Brain Injury, 2019
Tuomas Mäntykoski, Grant L. Iverson, Juuli Renko, Anneli Kataja, Juha Öhman, Teemu M. Luoto
Characteristics of the violence subgroup are presented in Table 2. Two of the most common primary assaulting mechanisms were being hit by hand 31.1% and being kicked 30.6%. A striking weapon was involved in 11.7% and a pushing-mechanism in 7.2% of the violence cases. The assailant was most likely to be unknown in 72.9% of the cases. Most of the assaults (33.3%) happened in nearby municipalities. The Tampere suburban area was the second most common violence-related TBI venue (30.6%). Only 16.2% of the assaults happened in the central area of Tampere. More than half of the patients arrived to the ED by ambulance (64.9%). Alcohol measurement was done in the ambulance for 46.8% and in the ED 41.4% of the patients. Blood ethanol levels were measured in 20.7% of the patients. Cerebrospinal fluid leakage was found in four (1.8%) patients, and haemorrhage from the nose and/or ears in 17.1% of the cases. Mandibular fracture was documented in 3.2%, fracture in the maxilla in 9%, and nasal bone fracture in 11.3%. The ED physician found a dental trauma in 6.3% of the patients. In 25.7% of the cases, there was a head or facial wound that required suturing.
Does the angulation of the mandibular third molar influence the fragility of the mandibular angle after trauma to the mandibular body? A three-dimensional finite-element study
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2018
Yeliz Kılınç, Zeynep Fatma Zor, Mehmet Kemal Tümer, Erkan Erkmen, Ahmet Kurt
Mandibular fracture patterns depend on multiple factors, including direction and amount of force, presence of soft tissue bulk, and biomechanical characteristics of the mandible such as bone density and mass, or anatomic structures creating weak areas. A significant relationship between fracture location and the presence of a tooth-bearing area has been reported (Lee and Dodson 2000). In human clinical studies, the presence of M3 has been repetitively shown to be associated with higher relative risk for mandibular angle fracture (Safdar and Meechan 1995; Tevepaugh and Dodson 1995; Lee and Dodson 2000; Fuselier et al. 2002; El-Anwar et al. 2016).