Jaw fractures in medical practice are quite common. Doctors note that injuries of the jawbone account for one seventh of the total number of fractures.
In order to recognize the problem in time and take the necessary measures, you should understand the existing types of injury and their symptoms.
What is a jaw fracture?
Fractures of the jaw represent damage to the jaw bone anywhere, accompanied by a violation of the integrity of the surrounding tissues. In this case, muscles, facial nerves, and vessels may be affected.
The causes of such injuries are various, but most often they are caused by mechanical stress: shock, fall, accident. In addition, there is also a pathological fracture that occurs as a result of external effects on the jawbone in the presence of chronic diseases such as bone syphilis, osteomyelitis, and tumors. So, in severe osteomyelitis, bone sections die, which leads to its spontaneous fracture.
How to recognize a jaw fracture
There are several signs that suggest the presence of a jaw fracture:
- When injured, a person feels severe pain.
- When you try to open or close your mouth, the pain intensifies, a click may be heard.
- The jaw can move to the side.
- With an open fracture , a rupture of facial tissues over the jawbone is observed.
- When the nerve endings are affected, some numbness is felt during touching the face.
- Headache, dizziness.
Symptoms may vary, it all depends on what part of the bone is damaged.
To establish the type of jaw injury, you should immediately contact a doctor and conduct a diagnostic analysis. It includes an external examination, x-ray examination.
A jaw fracture is often accompanied by damage to the brain or cervical spine. To exclude such complications, an additional analysis is carried out.
Types of jaw fractures
Jaw fractures have an extensive classification in several directions:
1. Separation by etiological or causal factor:
- the occurrence of a fracture of the jaw as a result of trauma;
- jaw fracture as a result of tissue and bone pathology.
2. Depending on the fracture line:
- longitudinal;
- direct;
- oblique;
- zigzag
- fragmented;
- transverse.
3. By the number of debris:
- multiple
- single;
- double;
- triple.
4. Depending on the location of the fracture:
- fracture of the lower jaw;
- fracture of the upper jaw.
5. According to the degree of violation of the jawbone:
- full;
- incomplete (cracks, breaks).
6. Depending on the degree of soft tissue involvement:
- closed fractures - soft tissues are not affected;
- open - integrity of soft tissues is broken.
In addition, jaw fractures are:
- with defects and without defects;
- combined.
Jaw fracture treatment
The main symptoms of fractures of the lower jaw are:
- pain;
- the inability to chew food due to pain;
- possible numbness of the chin, lips;
- malocclusion;
- nausea;
- dizziness.
In the process of diagnosis, the doctor, first of all, determines the general physical condition of the patient. For this, the pulse, pressure is measured. After that, in order to exclude traumatic brain injury, a tomography is performed.
During an external examination, painful spots, defects, hematomas are determined. A test is performed in which the alleged location of the fracture is revealed. After which an X-ray examination is carried out.
In the corners, the lower jaw has a very thin structure and a fracture is possible even with a minor impact or other lateral damage.
Often there are double, triple and multiple fractures of the lower jaw. The treatment of such injuries is complex and takes a longer rehabilitation period.
Therapy
When a fracture of the lower jaw is observed, treatment should be followed immediately - this will avoid many complications.
Before transporting a person to a medical facility, first aid should be provided to the patient. It is necessary to fix the lower jaw in a stationary state with a bandage or bandage.
The most common fractures of the lower jaw are:
- mental hole projection;
- mid jaw;
- articular process;
- jaw angles.
Swelling of the tissues often accompanies a fracture of the lower jaw. Treatment in this case begins with the application of a cold compress. After that, under local anesthesia, the doctor carries out the procedure for combining bone fragments, and then fixes the jaw for the entire period of treatment.
The bone of the lower jaw can be fixed with a nylon core or wire. In parallel, anti-inflammatory therapy is carried out, vitamins and means to strengthen the immune system are prescribed.
Maxillary fracture
The upper jaw is a paired bone, it is located in the center of the face and is involved in the formation of the nasal cavity, mouth, orbits. Fracture of the upper jaw is very dangerous. Firstly, the skull may be affected. Secondly, there is a risk of concussion or the development of a disease such as meningitis.
In addition to standard symptoms, fractures of the upper jaw can be accompanied by hemorrhage, hematomas in the eye area, visual impairment, and loss of consciousness. Respiratory and chewing functions are difficult. If a person cannot breathe, the airways and oral cavity should be freed from obstructing foreign bodies.
With such an injury, bleeding may open. To stop it, you should put on a swab or a pressure bandage.
Complicated jaw fracture
Complicated is a jaw fracture with a displacement, in which there is a violation of the normal location of bone fragments. May be complete and incomplete.
Complete fracture - the connection between the components of the bone is broken.
Incomplete - the connection between the components of the bone is not broken or slightly broken.
Fracture of the lower jaw with displacement initially requires the combination of fragments, removal of edema, after which rigid fixation is necessary.
In the case of a fracture of the upper jaw , its extension is often necessary. To do this, use a special orthopedic apparatus, which gradually returns the damaged bone to the correct position.
Such injuries are very dangerous because they can provoke asphyxiation, which, if untimely assistance is provided, can lead to death. To prevent choking, it is necessary to clean the oral cavity of foreign bodies, blood, and then place the person in a horizontal position, face down with a rolled blanket or clothes under the chest.
Splinting in jaw fracture
The main method of treating jaw fractures is splinting - this is the fixation of fragments using a special design of wire or plastic.
Splinting is of the following types:
- Unilateral - is used for fracture of one half of the jawbone. A wire is used that is attached to an injured area.
- Bilateral - the wire is used more rigid, hooks and rings are in addition installed.
- Bilingual - is used for fracture of the upper and lower jaws with displacement. A copper wire is used, which is attached to the teeth and fixes both jaws with rubber rings.
The splint fracture splint can also be plastic. It is placed under the chin, runs along the cheeks and is fixed with a bandage around the head. But, as a rule, this method is resorted to if urgent splinting is required (for example, when transporting a patient to a medical facility).
If a person has a complicated jaw fracture, splinting is carried out strictly after combining fragments. Additional external fixation devices may also be required.
Possible complications
Possible complications of fractures of the upper and lower jaws include:
- sinusitis;
- osteomyelitis;
- improper fusion of fragments;
- the joint is false.
Sinusitis most often occurs with a fracture of the upper jaw and is due to the presence of small bone fragments in the maxillary sinuses.
Osteomyelitis is a common complication of a fracture of the lower jaw. It is a purulent formation that affects the bone. In order to prevent the development of this pathology, antimicrobials, physiotherapy, and vitamins are prescribed.
An improperly healed jaw fracture can occur in the following cases:
- the patient turned to a medical institution late;
- the treatment regimen was disturbed;
- when a jaw fracture occurred, the splinting was performed according to an incorrectly selected method.
The situation can be corrected surgically (most often they do) or using an exhaust system.
A false joint can occur with osteomyelitis, is a violation of the jawbone with mobility in some departments. The treatment is only operational.
Rehabilitation
The recovery period after a fracture of the jaw includes the following steps:
- Fixation of fragments. A tire is used for a fracture of the jaw and some other types of fixing devices.
- Anti-inflammatory therapy. It includes the use of antibiotics, antifungal and restorative drugs.
- Proper oral hygiene. It is carried out both by the doctor and the patient himself. It consists in cleaning the tire, teeth from food debris, treating the oral cavity with special antimicrobial agents. Every day, rinse with a solution of soda, and after eating use antiseptics.
- Physiotherapy is a special gymnastics aimed at restoring the functions of the jaw. Exercises should start from the first day of the injury in order to prevent the formation of scars and to avoid such a complication as an incorrectly fractured jaw fracture.
To restore all the functions of the jaw, gymnastics should be performed daily. Its principle is the development of muscles and joints. To do this, you need to make massaging movements, and then proceed to the pronunciation of letters, sounds, opening your mouth wide. You can simulate chewing movements. At first it will cause pain, but gradually the discomfort will pass.
If a child is injured ...
According to statistics, this kind of damage is observed in boys aged 6 to 14 years, i.e. during a period of increased physical activity, then the number of accidents decreases. In girls, a similar dependence of the frequency of fractures on age is not observed. In any case, this injury is very unpleasant, but the worst thing is that it is mainly accompanied by craniocerebral injuries, a violation of the integrity of other bones and soft tissues. It is strictly not recommended to engage in amateur activity. At the slightest suspicion of a fracture, you should immediately seek qualified help.
When visiting a doctor, a medical history is compiled. It is not always possible to visually diagnose a fracture of the jaw, therefore, the specialist prescribes an x-ray examination without fail. According to its results, a treatment regimen is compiled. The rehabilitation process is not much different from that described above.
Nutrition rules
Due to the fact that the jaws are in a fixed position during therapy and rehabilitation, it is imperative to adjust the diet. Bone fuses within a month (at least), and all this time you should eat only liquid food.
Fractures of the jaw involve eating a meal that, by consistency, is not thicker than sour cream. An approximate menu may consist of soups with grated vegetables, fruit purees, dairy products, broths, various cereals. After removing the tire, it is necessary to start taking solid food gradually so as not to provoke gastrointestinal upset.
Breakfast may consist of a glass of kefir, liquid oatmeal, applesauce.
For lunch, you can cook any cereal, chicken or rabbit broth, drink a glass of orange juice.
As a snack, you can use dairy products. For dinner, you should prefer thin potato soup, fruit puree.