1 / 18

Expert Guide to Managing Facial Fractures After a High-Speed MVA

Learn how to approach facial fractures post-MVA, emphasizing clinical assessments to detect common injuries like orbital and Le Forte fractures. Find details on emergency management strategies and key pointers for successful treatment.

onaona
Télécharger la présentation

Expert Guide to Managing Facial Fractures After a High-Speed MVA

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Case Presentation Shiraaz Shaikjee 08 April 2008

  2. 41 yr old male • High speed MVA – 100 km/hr • Head on collision with a pedestrian • Restrained and airbag deployed • On scene – altered LOC, hypotensive and tachycardic. • Injuries – facial injuries, rib # L, L femur #

  3. Emergency management • Splint #, decompress r chest, sedate and intubate • Significant disruption of the facial bones • Lots of blood in oropharynx and nose • Packaged and taken to hospital

  4. Facial Fractures • Approach – clinical assessment standpoint • Look out for orbital blowout #’s • Search for Leforte #’s • Not to forget mandibular #’s • NB, start at one point and work systematically or in an orderly fashion

  5. LOOK • Swelling and deformity • Raccoon eyes/ Battles sign • Nasal #’s • Csf leaks • Lacerations • Always have a high index of suspicion for a c-spine injury in pts with significant head and facial trauma

  6. PALPATE • Skull and forehead • Orbits • Nasal bones • Maxilla and Zygoma • Mandible • Instability, depression, crepitus, fracture

  7. FRONTAL BONE # • Direct force • Intracranial injury because of damage to the posterior table of the sinus • Dural tears associated wih orbital roof #’s ------ lead to blindness • Clnically: disruption/crepitus of supraorbital rim or subcut emphysema

  8. Eye - Orbit • Open eye – paper clip • Cheimosis • Pupil, globe penetration, corneal laceration • Hyphema, subconjunctival hemorrhage • Full 360˚ of the orbit • BLOW OUT #

  9. Blowout # • 2 mechanisms • 4 clinical finding • Enopthalmous • Infraorbital anaesthesia • Diplopia • Step off deformity + subcut emphysema – pathognomonic Xray hanging tear drop sign

  10. Blow out #

  11. NASAL BONES • Palpate for obvious #’s • Biggest problem being that of hemorrhage • Rich blood supply – Littles area • May need packing – BOS

  12. MID FACE • Palpate maxilla and zygoma • Hemorrhage • Le forte #’s

  13. Le Forte #’s I/II/III

  14. What are the #’s???

  15. Mandibular #’s

  16. Mandibular #’s

  17. Thank You

More Related