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Fracture of the lower jaw in the chin department
05-09-2009
If the fracture line passes between the central incisors vertically down to the bottom of the chin department formed almost the same size fragments, which is attached to the same number of muscles. These fragments are in a state of dynamic equilibrium, the displacement of crude is not observed. However, due to the dominance of power over the chewing muscles medial wing-in the presence of a movable fulcrum of each fragments (articular head) there is a slight shift in the bottom of the body of the mandible outwards. Therefore, the lower edge of the chin a few splinters apart. Contact teeth papulose-papulose, as part of the alveolar bone fragments slightly tilted orally. In the case of passing the fracture plane at an acute angle to the longitudinal axis (line of fracture inside and outside of a compact disc is located at unequal distances from the midline) may offset bone fragments in the horizontal plane (The occurrence of one another).
Then comes the deformation of the dental arch and malocclusion will be more pronounced. A similar situation can be recreated in theory rather than seen in clinical practice. However, strictly vertically in the midline of the alveolar part to the lower edge of the chin fissure fracture is extremely rare, as the lower jaw is considerably thickened in the central sector at the expense of chin mound. Often it is passing through the alveolar portion between the central incisors, and passes chin hill and ends at the projection of the second incisor and canine. In this form of unequal size fragments, the larger of which are attached all the muscles that drive the lower jaw.
If the fracture line on the exterior and interior of a compact plate located on one level, the displacement of bone fragments can occur only in the vertical plane without significant malocclusion (loose contact of teeth on the side of the large fragments). More frequently, crack fracture is oblique to the outside of a compact disc to the lingual (line fracture on the outside of the plate is closer to the midline, and on lingual - more). The angle of the bevel slot fracture can be quite spicy, which creates good conditions for the displacement of bone fragments not only vertically but also horizontally. Under the influence of the lateral (to a lesser extent - medial) pterygoid muscle fragments are shifted toward the middle line, calling to each other. The middle line is shifted toward the fracture, dental arch is narrowed, teeth, contact breaks (dense papulose-papulose closure of small fragments, less dense papulose-papulose closure of molars and premolars and the absence of contact of incisors and canines - a large fragments).
Thus, at the turn of the body of the mandible to the chin to separate the character of displacement of bone fragments also depends on the localization of the fracture gap, severity of the bevel relative to the longitudinal axis of the body of the jaw, its length.
Complaints of patients are no different features. Note the marked swelling of the lower lip, cheek, chin and anterior part of the Wharton area with severe bruising. Bone protrusion palpated quite clearly in the lateral section of chin department jaw at the base of the canine or first premolar. There is a hematoma in the tissues of the lower body of the arches of the mouth and hyoid region within the incisors, canines and premolars with a torn wound mucosa at the level of the gums incisors. Less wound on the mucous membrane of the gums it. Value of dentitions affected by many factors and is presented above. Symptom load efficiently check, performing moderate pressure on the region of angles of the mandible toward the median plane. It will be positive in the chin department respectively palpable bone protrusion, as a symptom of the mobility of fragments. Roentgenograms of the mandible in the lateral line and little informative due to superposition of the shadow of the cervical spine. Need X-ray chin department.
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Articles for theme "fracture of the jaw":
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05-09-2009
Mandibular fractures most often occur in the region of its angle. This fracture is more often direct, sometimes - as reflected, ie at some distance from the place of the applied force. Ignoring this fact is often the cause of diagnostic errors, especially at the turn without bias. For the displacement of fragments of considerable importance is the localization of the fracture gap. If it passes anterior to the chewing muscles and the medial pterygium, or more precisely - within only a quarter of the front of their plane, the displacement of fragments more often than significant.
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05-09-2009
These fractures tend to occur at the site of application of force, ie direct. The clinical manifestation of a unilateral fracture of the lower jaw of any location, including the lateral part of the body of the jaw, is largely predetermined by the direction of the plane of the fracture and its location relative to the median line: the farther from it is a fracture plane, the greater the displacement of bone fragments. Before talking about the nature of the displacement of fragments of the mandible in its turn, it should be recalled that represent the plane and axis.
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05-09-2009
Based on the requirements of clinical practice, the body of the mandible conventionally divided into chin (between the moon-kami 3 1 3), the side sections (3 | 3 to 7 | 7), region of the angle (between 8 7 | 7 8 or recess 8 | 8 ).
When fractures of the mandible complaints of patients are diverse and largely dependent on the localization of the fracture and its nature. Typically, patients concerned about the swelling in admaxillary tissues, pain in a certain sector of the mandible, increasing when opening and closing the mouth, poor interdigitation.
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05-09-2009
Causes of displacement of bone fragments in mandibular fractures
The displacement of fragments of the mandible is due to the action of the applied force, under the influence of its own weight and strength reduction of bone fragments attached to the fragments of the muscles. The last factor is decisive. As already noted, the lower jaw is moved under the influence of two muscle groups: to raise (rear group) and down (front group) the lower jaw. All the muscles are attached in pairs and symmetrical points.
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05-09-2009
There are four variants of the mechanism of fracture of the mandible: bend, shear, compression, separation. The lower jaw, having an arched shape, when a mechanical force is experiencing stress of bone tissue in the most crooked, or the most delicate of areas. Established in the limits of the lower jaw are the foundation and condylar neck of the appendix, angle, area openings and canine chin, chin department. It is in these most «weak» ground breaking lower jaw as a result of its inflection.
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