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Unilateral fracture of the upper jaw
03-09-2009
In practice, the surgeon-dentist found unilateral or sagittal fractures of the upper jaw. They tend to occur when the injuring object has sharp edges and the force is applied downward in an oblique direction, mainly at the side of a single department or zone of the upper jaw of the upper lip with one hand. It breaks down the body of the upper jaw with a wing-offshoot sphenoid bone of the party or without it. In the area of the anterior and infratemporal walls (tuber) of the upper jaw fracture line passes above the bottom of the maxillary sinus, and in the hard palate - lateral of the median suture. On the midline of the hard palate line fracture never happens, because the force most often directed parallel to palatal buttress. Solid sky line fracture may have a zigzag or linear form. Thus, in this type of fracture formed by two unequal-sized bone fragments presented broken jaw with one hand and undamaged - on the other. Each of them includes the upper jaw, the palatine bone pterygoid bone sphenoid bone. Nasal septum combined with intact upper jaw. However, it can break if a crack fracture crosses the midline. Otlomlenny fragment is displaced downward and backward (the action of the applied force and the thrust of the medial pterygium muscle), as well as outwards (the action of the lower fibers of the lateral head pterygium muscles that attach to the outer surface of the pterygium sprouts sphenoid bone). This makes malocclusion.
When a unilateral fracture (eg, right), the patient complains of pain in the right upper jaw, with the increasing interdigitation or try chewing food, the inability to properly close his teeth, numbness all the teeth and gums of the upper jaw to the right, sometimes a foreign body sensation in the throat.
On examination indicated a unilateral (right) deformation of the face due to swelling of tissues of the upper lip, cheek and infraorbital area. There may be bleeding in these areas, bruises, wounds - traces of the applied force. The patient's mouth half open. The mucous membrane of the alveolar process between the central incisors (or the central and lateral cutter on the right) is broken. There is a hemorrhage of the upper set of arches of the mouth and above it on the side of a fracture within all the teeth. Palpable bone protrusion within the hematoma, including in the field skuloalveolyarnogo crest. Solid sky - marked hemorrhage, sometimes laceration of the mucous membranes. Discrepancy fragments can be so large that the wound reminds congenital cleft palate, which is visible through the nasal cavity. When pressing on the pterygoid bone sphenoid bone or the last molars detected visually and mobility of the fragment with palpation control in the skuloalveolyarnogo crest. Sometimes the teeth may be mobile, and between them runs the fracture. Percussion their moderately painful. Teeth in contact on the side of the fracture, and the more dense is the contact palatal tubercles upper jaw with teeth, buccal tubercles of the mandible. On the healthy side contact teeth. Symptom mobility fragments positive. When teeth percussion percussion sound on the low side of the fracture.
On radiographs of the upper jaw in front poluaksialnoy projection - lowering the transparency of the right maxillary sinus, destroying the integrity of skuloalveolyarnogo crest on the same side. On radiographs of the hard palate is visible line of his breakthrough.
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Articles for theme "fracture of the jaw":
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03-09-2009
Assume that the left is fractured along the middle and the right - the bottom type. Fracture line runs from the junction point of the frontal sprouts upper jaw with the nasal part of frontal bone on the left, extends on the inner wall of the orbit and beyond - in accordance with a fracture in Le Fort II, but with only one left. Nasal septum is broken at different levels depending on the transmission line fracture of nasal bones. The right line of the fracture begins at the pear-shaped holes, and further extends the type characteristic of a fracture in Le Fort III (ris.
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03-09-2009
For convenience of presentation, suppose that the left fissure fracture runs along the upper type, and the right - on average. The line is a fracture in the frontal connections sprouts upper jaw with the nasal part of frontal bone. Left it extends characteristic of Le Fort I (ris.3.12), and the right - for the Le Fort II (see the relevant section, as outlined above). Patients may complain of pain in the upper jaw, with the increasing interdigitation or attempted biting or chewing food, improper closing of the teeth, foreign body sensation in the throat, choke and retch, insufficient opening of the mouth, double vision.
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03-09-2009
Fracture of the upper jaw of Le Fort III (bottom type)
Fracture line passes through the edge of pear-shaped holes, backwards and slightly above the bottom of the maxillary sinus. It crosses skuloalveolyarny ridge, goes through the hill of the upper jaw and extends to the lower third of the pterygium sprouts sphenoid bone (see 3.10). Sometimes pterygoid bone is not broken off with the upper jaw, and is separated from her mound at their place of seam. In these cases, pressure on the hook pterygium the process, as described above, is not accompanied by pain and may complicate diagnosis.
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03-09-2009
Fracture line passes through the place of the frontal sprouts upper jaw with the nasal part of frontal bone on the inner wall of the orbit to the infraorbital fissure. Further extends anteriorly on the lower wall of the orbit to the infraorbital region, crossing his or skuloverhnechelyust Board the seam, or close to it. Then comes down and backwards on the front surface of the upper jaw, extending to the pterygoid bone sphenoid bone (sometimes on the border of the upper and middle third) (ris.3.7).
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03-09-2009
The line is a fracture at the junction of the frontal sprouts upper jaw with the nasal part of frontal bone in her lattice notch. The front edge of the latter is connected to the nasal bones, and the rear - with the front edge of the plate perforated ethmoid bone, which is involved in the formation of the skull base in front of his pit. Rear bow sections of the frontal bone contains cells in contact with the ethmoid bone and forming the roof of its cells. Then the fracture line passes through the inner wall of the eye socket to the junction of the upper-and infraorbital slits, passes to the outer wall of the orbit, extending to her up and anterior to verhnenaruzhnogo its corner.
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