Cases reported "Mandibular Fractures"

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1/7. Horner'sy syndrome and its significance in the management of head and neck trauma.

    The history, mechanism and aetiology of Horner'sy syndrome is presented and the pharmacology of the pupil is discussed. The case reported is a rare combination of Horner's syndrome in a patient who sustained bilateral fractures of the mandible and a chest injury. It is emphasised that the miotic changes in Horner's syndrome, in combination with head injuries can lead to confusion in diagnosis and the potential anaesthetic hazards and their influence on the management of the facial injury are outlined.
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2/7. Options for immediate reconstruction of the traumatized temporomandibular joint.

    The management of condylar fractures is one of the most controversial topics in the repair of the maxillofacial skeleton. An extensive volume of literature exists describing the various indications for a specific treatment of this injury. This article outlines the absolute and relative indications for an open procedure and describes three different modalities for the immediate reconstruction of the temporomandibular joint system. Three different case reports are used to illustrate the respective procedures--replacement of the temporomandibular joint with autologous rib graft, replacement of the temporomandibular joint with an alloplast, and vertical ramus osteotomy for repositioning of the condylar stump. The discussion section reviews the findings and preferences of various treatment modalities described in the literature, along with the advantages and disadvantages.
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3/7. The importance of early recognition of condylar fractures in children: a study of 2 cases.

    Maxillofacial fractures in general and mandibular fractures in particular seem to be less common in children than in adults; however, this finding might be influenced by the fact that condylar fractures in children are often undiagnosed and so the true incidence is likely to be higher than that reported in literature. Traumatic lesions of the temporomandibular joint often are overlooked as they can apparently occur with relatively little pain, few clinical signs, and insufficient reaction by the child to alert an adult to the seriousness of the injury. Only 1 to 2 years later, when growth disturbances appear, are they perceived as a problem, but by that time, the dysplastic growth pattern has stabilized and will continue over a period of years. The problem is frequently underestimated because of the difficulties inherent in pediatric pain assessment. The fact that the mechanisms of pain perception in children differ somewhat from adult pain perception mechanisms is one factor that can make pediatric pain assessment difficult. This paper outlines 2 case reports that draw attention to pain in children in the case of temporomandibular joint injury. The inability to assess pain adequately may lead to a delay in diagnosis and treatment and possibly result in future growth disturbances and facial asymmetries.
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4/7. Complications in the use of compression plates in the treatment of mandibular fractures.

    The use of internal rigid fixation with plates in the treatment of facial fractures continues to increase in popularity. The principal advantage is in avoiding the use of maxillary mandibular fixation (intermaxillary fixation), thus enabling early return of function. However, there are clear guidelines for their use and technique of placement. A case is reported that demonstrates several avoidable complications in the use of compression plates and outlines the principles for the correct use of bone plates in mandibular fractures.
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5/7. The use of two-dimensional CT reconstruction to demonstrate a vertical fracture of the condylar head.

    A case of vertical fracture of the condylar head is described. The history, investigation and treatment is outlined with emphasis on the use of two-dimensional CT reconstruction to demonstrate the fracture.
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6/7. Delayed rupture of the spleen in a patient with mandibular fracture.

    A case of blunt abdominal trauma with subsequent damage to and rupture of the spleen is presented. Clinical manifestations, diagnosis, and sequelae and complications of injury are discussed. This case report demonstrates the insidious nature of trauma to the spleen and the ultimate dangers of delayed rupture. Treatment and disposition of the case are discussed and recommendations for physical examination of the patient who has suffered trauma to the abdomen are outlined.
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7/7. facial nerve injury secondary to lateral displacement of the mandibular ramus.

    We describe two cases of facial nerve injury after lateral external dislocation of the mandibular ramus, an event not found in the reviewed literature. We discuss the possible pathogenesis and outline the therapy.
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