医学资料口腔颌面外科李祖兵下颌骨骨折ppt课件.ppt

Mandibular Fractures;History;Ancient Egypt;“If thou examinst a man having a fracture in his mandible, thou shouldst place thy hand upon it…and find that fracture crepitating under they fingers, thou shouldst say concerning him: one having a fracture in his mandible, over which a wound has been inflicted, thou will a fever gain from it.” ------Edwin Smith The cause of death was believed to be sepsis;Ancient Greece;Bandages, first mentioned by Hippocrates, gained acceptance as a standard of care when John Rhea Barton described his Barton bandage;“Displaced but incomplete fractures of the mandible where continuity of the bone is preserved should be reduced by pressing the lingual surface with the fingers while counterpressure is applied from the outside. Following the reduction, teeth adjacent to the fracture are fastened to one another using gold wire.” ------Hippocrates;“Modern” Europe;America ;Thomas Gunning was the first to use vulcanite in a custom-fitted splint to immobilize mandibular fragments.;America ;Thomas presented a technique of intraoral open reduction with silver wire osteosynthesis. The spiral spring-like termination was tightened intermittently “until union was secured.”;Anatomy;Bony Landmarks;Anatomic units of the mandible;Trajectories of the mandible;Occlusion;Angle’s classification;Common Sites of Fracture;Fracture Frequency;;Innervation;Anatomy - Mental foramen;Anatomy - Mandibular foramen;Arterial supply;Musculature: Jaw Elevators;Musculature: Jaw Depressors;Muscles of mastication, which have a displacing influence on mandibular fractures;The tension forces along the alveolar border (---) and compression forces along the lower border (+++). The arrows indicate muscular tension;Factors in fx displacement;Classification by type of fracture;Classification by localization;Classification of condylar fx.;Classification of condylar fx.;Favorable Fractures;Unfavorable Fractures;;;;;;;;;;;;;;;;;;Diagnosis of Mandibular Fx;Evaluation - History;Trauma i