ORAL & MAXILLOFACIAL FRACTURES are the types of soft and hard injuries involving the skeletal structures of the face and also involve major anatomical structures such the organs (eyeball, glands, tongue etc.) and blood vessels and nerves.
For many obvious reasons such as road traffic accidents, assaults, sports injuries, fall from height etc leads to such fractures of the face.
Primary management and care is the golden period after any such facial trauma to identify and prevent any life threatening injuries due to blood loss, aspiration of blood contents into lungs or any organ damage involving the brain and its surrounding blood clots.
Soft tissue injuries on face
Once any fatal injuries are managed or ruled out, facial fractures and soft tissue injuries are then addressed accordingly. Soft tissue injuries involves any part of the face that might be as simple as small abrasion injuries to large lacerations or tissue avulsion and crush damage leading to heavy blood loss.
Soft tissue injuries are mostly managed by suturing, pressure dressing and ointments. If they are clubbed with hard tissue fracture, then these heavy laceration are used to enter the fracture sites and fix.
Hard tissue injuries of face are majorly divided into 3:
- upper third/ frontal/ forehead
- Middle third/ cheek & nose/ Maxilla or upper jaw
- Lower third/ mandible or lower jaw
Facial fractures either occur independently or mostly occur in combination with the surrounding bones.
Fractures involving the upper jaw (Maxilla)
Upper jaw or maxilla is the main subunit centered in the middle that is connected to all the proximity vital structures. Fracture can be either simple lines or crushed injuries causing disfigurement. They can involve the upper teeth, cheek bones, nasal bones, orbit(eye) bones and others that required fixation using implants that are biocompatible and Nobel metal.
Maxillary and nasal bone fracture
Maxillary fractures with loss of teeth
Cheek bone fractures
Cheek bones are reduced and fixed with implants (plates and screws)
Types of fracture based on teeth stability
Fractures involving the lower jaw (Mandible)
Lower jaw or the mandible is subdivided into many areas that are fractured either independently or in combination with other parts of the same jaw or with the opposite jaw. According the fracture sites are reduced and fixed using implants.
Fractures involving the Forehead (Frontal)
Forehead injuries are critical as they involve the outer portion of the brain and causes CSF leak. These injuries are mostly managed with titanium mesh to provide cosmetic reconstruction
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