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At least 19 recordsLinked to original sources

An extraction complicated by lateral and medial pterygoid tethering of a fractured maxillary tuberosity.

We report a case in which the extraction of an upper second molar was complicated by a maxillary tuberosity fracture. Delivery of the tooth and bone fragment under local anaesthesia was unable to be achieved because of pain, brisk bleeding and tethering by the lateral and medial pterygoid muscles. The eventual removal of the fragment under general anaesthetic required the control of haemorrhage deep within the infratemporal fossa. When this complication is recognised by the general dentist the maxillary tuberosity should not be removed and the patient referred to a specialist unit.

Exostoses↗

[Mandibular and maxillary fractures in dogs and cats].

Fractures of the mandible and maxilla are often caused by car accidents or by falling from a height. Frequently the fractures are open, especially when the fracture is located rostrally. During diagnostic work-up, special attention should be given to concomitant injury of the brain, and to cervical and thoracic injuries. The principles of treatment for jaw fractures are identical to those for complicated long bone fractures. Adaptations of techniques are necessary because of the need for undisturbed food intake, the presence of dental elements in the fragments, the poor soft tissue coverage especially in the rostral part of the mandible, and the typical mechanical load of the bones. The dental roots should be avoided when possible. Pharyngostomy prior to fracture treatment allows optimal assessment of the occlusion during surgery. In general, the treatment should permit non-supported food intake by the patient after surgery.

Animals↗

The morbidity associated with fifty maxillary fractures treated by closed reduction.

Fifty patients with maxillary fractures treated by closed reduction over an 85 month period at a Level I trauma center were reviewed. Thirty patients (60%) experienced forty-one midfacial complications. The most frequent problems were infraorbital nerve paresthesia (12), enophthalmus (5), septal deviation (3), and altered vision (3). No relationship could be established between complications and age, sex, cause of injury, or the method of suspension used. Most complications were related to concomitant injury or the concurrent management of fractures of other facial bones. Only eight problems (16%) were directly attributed to the closed reduction of maxillary fractures. Patients treated by closed reduction and maxillomandibular fixation without suspension experienced no surgical complications.

Adolescent↗

Miniplate fixation for repair of mandibular and maxillary fractures in 15 dogs and 3 cats.

Maxillofacial miniplates and screws were used for skeletal fixation in 15 dogs and 3 cats that sustained a variety of mandibular and maxillary fractures. These implants were used as neutralization or buttress fixation in 11 caudal (junction of the ramus with the mandibular body) and 2 rostral mandibular fractures, 4 maxillary fractures, and 2 zygomatic arch fractures. All but one of the fractures healed with appropriate occlusion and excellent function. In one case of a rostral mandibular fracture, soft tissue dehiscence occurred accompanied by a loss of the fixation and subsequent distraction of the bone fragments; reasonable function was obtained by performing a rostral mandibulectomy. Plate contouring and application of the miniplates along the appropriate biomechanical lines of stress was easily performed and permitted the biomechanical principles of tension band fixation to be applied in most cases. Miniplate fixation, either used alone or in combination with other fracture fixation techniques, achieved sufficiently rigid skeletal fixation to provide uncomplicated healing and good to excellent functional and cosmetic results in 14 dogs and 3 cats.

Animals↗

Fracture of the occipital condyle as an incidental finding during CT-evaluation of a maxillary fracture.

A 43-year-old male presented with blunt facial trauma after a motor-vehicle accident. CT-evaluation revealed a right-sided maxillary fracture and a fracture of the left occipital condyle. The fracture of the occipital condyle is potentially unstable and fatal cases have been described. Plain radiographs are not diagnostic. This occipital condyle fracture was an incidental finding during CT-evaluation of a maxillary fracture and is probably the first case with coronary CT scans of this type of fracture.

Adult↗

Direct external pin fixation of maxillary fractures using premaxillary pins.

A simple technique for the fixation of maxillary fractures using premaxillary pins is described. Three case reports have been used to illustrate the technique which is recommended when maxillary fractures occur in conjunction with craniofacial or multiple injuries and when conventional methods of fixation are difficult to apply.

Adolescent↗

Miniplate reconstruction of severely comminuted maxillary fractures in two dogs.

OBJECTIVE: To describe the treatment of severely comminuted maxillary fractures that resulted in separation of the maxilla from the base of the skull in 2 dogs. The structural areas of support, identified by thicker areas of bones of the skull, were used as a guide to apply buttress plate fixation, with miniplates using these apparent structural buttresses. STUDY DESIGN: Case report. SAMPLE POPULATION: A 1-year-old Borzoi and a 5-year-old German shepherd dog. RESULTS: Fractures were repaired in a single procedure that resulted in excellent postoperative occlusion, immediate function, and cosmetic result. Healing was uneventful. Full function and excellent cosmetic appearance were still evident at 5 years, and the miniplates have not been removed. CONCLUSIONS: Long-term outcome appeared to justify surgical reconstruction of these severely comminuted fractures with miniplate methods similar to those used in human maxillofacial surgery. Miniplates were easily contoured 3-dimensionally and placed along apparent lines of buttress support. Miniplate fixation provided a simple method to secure the bone fragments with excellent stability while maintaining both bony and soft tissue stability. CLINICAL RELEVANCE: Severely comminuted maxillary fractures in the dog may be repaired with miniplate fixation, using fixation principles identical to those used for similarly complex fractures in human maxillofacial surgery.

Animals↗

Comparison of the morbidity associated with maxillary fractures treated by maxillomandibular and rigid internal fixation.

OBJECTIVE: To compare the type and incidence of morbidity encountered by two groups of patients with maxillary fractures, one treated by closed reduction and maxillomandibular fixation and the other by open reduction and rigid internal fixation. STUDY DESIGN: This was a retrospective review of records for all patients with maxillary fractures treated over a 10-year period. Age, sex, mechanism of injury, anatomic location of fracture, treatment modality, and complications were identified. Two populations of patients, those treated with closed reduction and maxillomandibular fixation and those treated with open reduction and rigid internal fixation, that were similar in size (n = 50), age, sex, and anatomic distribution of fractures were compared. RESULTS AND CONCLUSIONS: This study indicates that patients with maxillary fractures treated with either closed reduction and maxillomandibular fixation or open reduction and rigid internal fixation will encounter postoperative problems with a near equal frequency (60% to 64%). Regardless of the technique used, no relationship could be established between age, sex, or cause of injury. The more superior the level of the fracture, the higher the rate of adverse sequelae.

Adolescent↗