19 February 2009

fracture mandible and airway obstruction

Fracture mandible that will increase the risk of airway obstruction mostly appears in 2 form.
  1. Fracture bilateral symphysis of mandible
  2. Fracture bilateral condyle of mandible

fracture bilateral symphysis of mandible

First, the symphysis acted like free segment (coz fracture bilat.), suprahyoid muscle (ex. anterior belly of digastric) will pull this segment back, The oral cavity appeared smalller, tongue have no space to occupy. This sequence make patient difficult to breath.

suprahyoid muscle

Latter, the fracture of bilateral condyle of mandible, in this type when patient lie down the mandible will retrude. In the same sequence, tongue have no space to occupy and patient is hard to breath.

Thus the patients in these two type (maybe) can't lie in supine position, the best position is lie on one side or semi supine position to make sure the fracture fragment will not retrude posterior.

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