Features and classification of injuries of the maxillofacial region. Sprains and fractures of teeth. Fractures of the mandible. Jawfall: causes, clinical manifestations. The anatomical shape of damaged residues. Treatment of mandibular fractures.
Аннотация к работе
1. Features and classification of injuries of the maxillofacial region Questions persist traumatology an important medical and social problems due to intense urbanization , increasing number of vehicles , the pace and rhythm of life are increasing from year to year . In all countries, in accordance with the frequency and severity of injuries , the growing number of injuries suggests that the threat of injury for people aged up to 60 years longer than cardiovascular disease , as well as malignant tumors ( VA Kozlov , 1988). Together with a general increase in injuries observed increase in the frequency and severity of maxillofacial injuries, and combined defects. This is evidenced by a large number of Russian studies ( VA Petrenko and et al. , 1999; Sysolyatin PG , IA Arsenova , 1999) as well as foreign scientists (Y. Jallut et al., 1992 ; Hoffmeister et al., 1992). Number of maxillofacial injuries in the total number of bone lesions ranged from 3.2 to 3.8% ( NM Alexandrov and colleagues . , 1986). Number of patients with facial trauma in the total number of stationary dental patients , in accordance with the materials individual creators Rasen and ranges from 21 to 40% ( VV and Burdin et al. , 1998). Almost all of the creators noticed by improving facial fractures by 10-15 %, which should be considered when organizing stationary , as well as outpatient treatment . These data provide a basis for planning dental treatment , as well as baseline data to determine the number of hospital fund calculations required number of materials, devices for the treatment of patients with traumatic injuries of the maxillofacial region . Often defects of the maxillofacial region are found in people of working age from 18 to 50 years - 91%. Marked seasonality of injury in the summer and autumn months, the number of patients with facial injuries is increasing.This is explained by an increased frequency of road and street injuries, and injuries associated with agricultural activities . Studies have demonstrated that the first place of injuries maxillofacial occupy : home (83%) , motor ( 12%), manufacturing (4.5% ), sports (0.5 %). Home injury in the bulk of cases was accompanied by alcohol intoxication . It is worth noting the increase in the number of gunshot wounds of the maxillofacial region in recent years. Number of mandible fractures from 77 ranges from 95 % , the upper jaw 3 to 20 % , both jaws 2 to 8 %. Injuries maxillofacial respectively distributed localization followed way: facial soft tissue defects in 19% of fractures of the zygomatic bone 15% , fractures of the nose 4.5% higher jaw fractures 3.5% , mandibular fractures by 58%. A certain regularity between periods do appeals victims in institutions, localization, overlooking injury , as well as the nature of the defect. In the study of the record sheets , we found that on the first day after the injury in the emergency station approached 92 % of patients with soft tissue defects person gunshot defects - 89 % , fractures of the nose - 68% , multiple injuries of facial bones - 69 % double mandibular fractures - 58 %. In the most recent period of 10 days after the injury , patients with fractures received cheek bones - 32% , single mandibular fractures - 18%, numerous injuries bones little face - 31 %. Based on the study of the structure damage maxillofacial area was created a huge amount of their classifications. In compiling the classification biggest challenge is the selection of indicators that need to enter into it . The current level of computer technology allows you to enter to determine the greatest number of indicators. From a scientific point of view, this approach is understandable , but for everyday medical practice needs a short , comfortable , easy to remember classification . It is necessary that at diagnosis were provided by the following factors : localization , respectively - soft tissue injuries specific anatomical area with damage to major blood vessels , nerves , tongue , salivary glands , trauma maxillofacial skeleton ( mandible , maxilla , zygomatic bone , nasal bones ) ; according to the source of mechanical damage , gunshot , burns, frostbite ; according to the nature injured - Combines, Combines, through blind , tangents , penetrating ( the oral cavity , maxillary sinus , nasal cavity, orbit , pharynx ) . The proposed structure of the diagnosis are all part of the external skeleton , as it is the definition of damage needed to select the method of treatment. In the soft tissues are only those organs and systems , the failure of which determines the nature and source of injury . The need to provide penetrating and non-penetrating wounds yavna as for penetrating wounds twice as heavy as more than a festering , gapping , and more adverse outcomes . Separation wounds upper, middle and lower zones of the face allows you to emphasize bone damage associated with features of the anatomical structure , their multifunctional purpose. 2 . Sprains and fra