← H&N trauma Test
5 Written Questions
5 Matching Questions
- Describe Champy lines of osteosynthesis.
- Absolute and relative indications for open reduction of subcondylar fx
- What is shown in a Water's view film?
- What are class II and III occlusion?
- Treatement of posterior table frontal sinus fractures.
- a If no displacement or e/o CFS leak, observe and give abx. If displaced, obliteration and possible repair of dural tear. Cranialization reserved for fracture with significant bone loss or comminution.
- b Absolute
1. Dislocation into middle cranial fossa
2. Lateral extracapsular displacement
3. Inability to obtain adequate occlusion with closed reduction
4. Open joint with foreign body
1. Bilateral subcondylar fx's in edentulous patient (splinting impossible)
2. When splinting not recommended for medical reasons
3. Bilateral fractures associated with comminuted midfacial fractures
"ideal lines of osteosynthesis" across the mandibular angle where the compressive and tensile forces from mastication can be countered with only monocortical fixation
Class II: retrognathism
Class III: prognathism
upper 2/3 of facial bones, maxillary sinuses
5 Multiple Choice Questions
- rapid rewarming in circulating water. avoid rubbing and dry heat as both of these predispose to liquefactive necrosis. surgical debridement not indicated for 3 weeks for final demarcation of injury
- symphysis and condyle of contralateral side
1. Temporalis pulls coronoid posterosuperiorly.
2. Lateral pterygoid pulls condyle anteroinferiorly.
3 & 4. Masseter & medial pterygoid pull the angle anterosuperiorly.
5 & 6. Geniohyoid and digastric pull mentum inferoposteriorly.
- Obliteration vs. close monitoring with CT scans (in reliable patient only).
5 True/False Questions
What is shown in a submental vertex view film? →
Describe vertically unfavorable mandible fractures. → Usually involve the body and sympysis-parasymphysis areas.
The fracture line is posterior on the lateral cortex and anterior on the medial cortex. Therefore, the portion of the mandible posterior to the fracture is pulled medially, displacing the fracture. The mylohyoid is the primary muscle displacing the fracture.
Long-term complications of orbital blow out →
Some say panorex for subcondylar. Otherwise, Towne's view.
type of fracture most often associated with a mandibular body fracture → symphysis and condyle of contralateral side
Types of mandible fractures that require treatment with soft diet only (no MMF or ORIF) → symphysis and condyle of contralateral side