What threatens a person who has a broken jaw?
Dear Natalia!
A jaw fracture itself entails a loss of general ability to work from 10 to 20% (clause 44 of the Table of percentages of permanent loss of general ability to work as a result of various injuries, poisonings and other consequences of external causes, which is an appendix to the Medical criteria for determining the severity of harm caused to human health , approved by Order of the Ministry of Health and Social Development of the Russian Federation dated April 24, 2008 N 194n.
In this regard, actions to cause such harm to health as causing long-term health disorder or a significant permanent loss of general ability to work by less than one third are subject to qualification under Part 1 of Art. 112 of the Criminal Code of the Russian Federation and is punishable by restriction of freedom for a term of up to three years, or forced labor for a term of up to three years, or arrest for a term of up to six months, or imprisonment for a term of up to three years.
If the actions of the perpetrator contain the following qualifying characteristics:
a) in relation to two or more persons;
b) in relation to a person or his relatives in connection with the performance of official activities by this person or the performance of public duty;
c) in relation to a minor or another person who is known to be in a helpless state by the perpetrator, as well as with special cruelty, humiliation or torture for the victim;
d) by a group of persons, a group of persons by prior conspiracy or an organized group;
e) for hooligan reasons;
f) for reasons of political, ideological, racial, national or religious hatred or enmity, or for reasons of hatred or enmity towards any social group;
h) using weapons or objects used as weapons,
his actions are subject to qualification under Part 2 of Art. 112 of the Criminal Code of the Russian Federation and are punishable by imprisonment for a term of up to five years.
Intentional infliction of moderate harm to health, committed in a state of sudden strong emotional disturbance (affect) caused by violence, mockery or grave insult on the part of the victim or other illegal or immoral actions (inaction) of the victim, as well as a long-term psychologically traumatic situation that arose in connection with systematic illegal or immoral behavior of the victim, subject to qualification under Art. 113 of the Criminal Code of the Russian Federation and is punishable by correctional labor for a term of up to two years, or restriction of freedom for a term of up to two years, or forced labor for a term of up to two years, or imprisonment for the same term
Intentional infliction of moderate harm to health, committed in excess of the measures necessary to detain the person who committed the crime, is qualified under Part 2 of Art. 114 of the Criminal Code of the Russian Federation and is punishable by correctional labor for a term of up to two years, or restriction of freedom for a term of up to two years, or forced labor for a term of up to two years, or imprisonment for the same term.
Causing a fracture of the jaw due to negligence is practically excluded, since in practice in almost 100% of cases it is the result of a blow to the jaw with a fist, foot or head with a significant concentration of force (in most cases by persons with special combat, sports or other training).
Causing a fracture of the jaw in conditions of necessary defense, even if its limits are exceeded, does not entail either criminal or administrative liability.
First aid for a broken jaw
The very first thing to do if a person breaks their jaw is to call an ambulance. After this, measures can be taken to alleviate the victim’s condition:
- Since damage most often occurs in the event of an accident, fights, or falls, first of all you need to make sure that the person’s life is not in danger.
- If there are several non-gunshot injuries, the jaw should be addressed first. The exception is open fractures of other bones if the head injury is closed.
- If there is bleeding, apply a clean, preferably sterile, cloth to the wound. If the damage is minor, cotton wool will do.
- If the patient is unconscious, carefully turn him on his side. Clear your mouth of blood clots and vomit. This must be done extremely carefully, wrapping your finger in a clean cloth.
- Then you should put the patient in a comfortable position and try not to move him anymore. If the patient is conscious, a sling-shaped bandage is applied to the broken jaw, as in the photo on the right.
- Ice is applied to reduce pain. If possible, it is worth giving the victim painkillers. In this case, an intramuscular injection will be most effective. Analgin, Naproxen, Revalgin are suitable tablets.
Since the patient is unable to swallow, the painkiller tablet must be crushed and dissolved in water. If the person is unconscious, you can pump the liquid into a syringe without a needle and gently pour the medicine directly down the throat.
Can the upper jaw break?
Maybe, but doctors admit that this is a very rare situation. Due to anatomical features and lack of mobility, even in the most complex accidents, the upper jaw often remains intact. However, experts also emphasize that when the upper jaw is damaged, the symptoms and consequences are much stronger, they more often lead to death.
A fracture of the upper jaw is much more serious and dangerous than the lower jaw
The mandibular bone is massive and mobile, protrudes forward, therefore, with any external influence on it, it “suffers” first of all. According to statistics, it is damaged in 80% of cases of the total number of injuries to the bones of the facial skeleton.
Healing time and consequences
How long it takes for a jaw fracture to heal depends on the condition of the patient’s body, as well as the severity of the injury and the efforts made to eliminate it. For a young, strong body, 3-6 weeks is considered the norm, so a broken jaw in a child heals much faster than in an elderly person.
On average, it is customary to take into account a period of 1 - 3 months. In some cases, treatment may take about 6–8 months, especially if it is necessary to reposition the fragments.
Particular attention should be paid to the issue of how to develop the jaw after a fracture. Many people experience jaw clicking for a while after a fracture. This may be due to the formation of a bone growth in the joint area, but this defect can resolve itself as the cartilage tissue is replaced. Some consequences of a displaced jaw fracture must be corrected by a facial plastic surgeon.
One more point: is it possible to practice boxing after a broken jaw? After a full recovery, returning to sports is possible, but it is important that the bone is fully formed and strengthened.
Injuries of this kind are very serious, and therefore their treatment must be treated extremely responsibly. Additionally, you can familiarize yourself with the topic in the video in this article.
Symptoms and signs
The clinic of a jaw fracture manifests itself quite intensively. It is almost impossible not to notice the damage, as it causes great discomfort. The symptoms of jaw fractures from impacts are especially clear, as they can be accompanied by characteristic visual manifestations, including displacement of fragments.
The main symptoms of a jaw fracture are as follows:
- severe pain, especially when moving the jaw;
- You may feel numb after a jaw fracture;
- swelling, swelling of the jaw after a fracture;
- bruise or hematoma after a jaw fracture;
- hemorrhage, usually in the mouth or nosebleeds;
- distortion of facial contours;
- violation of orientation in space;
- curvature of the dentition;
- change in bite;
- violation of speech and swallowing functions;
- increased salivation.
You should not rely solely on existing signs, since determining a jaw fracture is not enough. It is necessary to find out its exact location and severity, as well as determine the optimal treatment strategy.
Features of treatment
Treatment for such injuries can take several months. Recovery after a jaw fracture also takes 1 - 2 months, which is associated not only with limited mobility of the damaged area, but also with the peculiarities of the regime, nutrition, etc. To restore normal speech and chewing functions, it is necessary to carefully develop the jaw after a fracture, because prolonged immobilization leads to the loss of former abilities.
Immobilization and surgical splinting
An important condition for proper bone healing is immobilization of fragments. They must be kept in the correct position and prevent displacement during the formation of osteoid callus.
To do this, fixation of a jaw fracture is used using the following methods:
- staples;
- plates;
- screws;
- knitting needles;
- hooks;
- osteoplast glue;
- bandage;
- external fixation systems.
If there is a fracture of the maxillary process, it can be fixed with a screw. But a double jaw fracture is more reliably immobilized using Kirschner wires. To install them, surgery is performed on the jaw during a fracture in order to reposition the fragments and perform osteosynthesis. It may be necessary to remove teeth at the fracture site.
A simple injury may be limited to conservative treatment. In extreme cases, surgery on the jaw after a fracture of this kind will involve the installation of braces or other external fixators. After removing them, you need to take care of how to develop the jaw after a fracture.
Drug therapy
To alleviate the patient's suffering and speed up recovery, medications are used.
The main drugs are:
- painkillers - to reduce pain after a jaw fracture;
- anti-inflammatory drugs - help relieve swelling after a jaw fracture and prevent the development of inflammation;
- antibiotics – are necessary to prevent wound infection, but instructions for taking them are prescribed exclusively by a doctor;
- mineral and vitamin complexes - help strengthen the body, since it will be more difficult to recover from a jaw fracture if there is a deficiency of necessary substances.
Nutritional Features
A separate point should be considered regarding nutrition during a jaw fracture. It is extremely inconvenient and painful for the victim to eat familiar foods, so the diet needs to be reconsidered during treatment.
What can you eat after a jaw fracture:
- puree;
- mousses;
- jelly;
- jellies;
- soups;
- milk products;
- boiled porridge.
It is necessary to maintain a balance of nutrients so that rehabilitation after a jaw fracture occurs without complications. Any solid food is strictly prohibited; only what does not require chewing is allowed. As you recover, you need to gradually introduce familiar foods so that your jaws and gastrointestinal tract get used to it after a long period of inactivity.
Since the broken areas are securely fixed during healing, it is most convenient to eat food through a straw. There are also special drinking bowls on sale into which food can be loaded in liquid form.
What needs to be done during the rehabilitation period?
- After the operation, it is allowed to eat exclusively liquid food and broths: it is recommended to eat food through a straw. Later, when the splint is removed (after about 21 days), you are allowed to eat food that has been blended and has a pureed consistency, as well as ground meat. A gentle diet must be followed for at least another month from the moment the tires are removed,
- you cannot open your mouth and strain your jaw: you will have to say “no” to meeting friends, communicating with colleagues, talking and laughing,
- it is necessary to follow the recommendations of doctors and take prescribed medications and drugs,
- It is important to undergo a course of physiotherapy procedures that promote accelerated tissue restoration: they can be carried out no earlier than 3–5 days after surgery. This could be magnetic therapy, electrophoresis,
- physical therapy: it is done after removing the fixing splints,
- undergoing routine examinations: they are carried out at least once a week until complete recovery.
Do not open your mouth or load your jaw
Diagnostics
At the initial stage, the doctor will listen to the patient’s complaints and find out the mechanism of injury. Next, the specialist proceeds to an examination, which allows him to obtain a lot of valuable information. In severe displaced fractures, the diagnosis can be made already at this stage.
The mobility of fragments in a complete fracture can be determined by palpation. Based on these data, the location and direction of the fracture can be assumed.
Accurate diagnosis is carried out on the basis of radiographic examination. The image clearly visualizes the fracture line and the direction of displacement of the fragments. Computed tomography can provide more detailed information. This technique makes it possible to take pictures of layer-by-layer sections of the damaged area, as well as determine the condition of the soft tissues and the position of the fragments relative to other anatomical structures.
When a fracture occurs in the area of the alveolus, the teeth suffer. The dentist must determine which ones can be attempted to be preserved. For this purpose, the viability of the pulp is determined using EDI. In doubtful cases, the study is repeated after 1-2 weeks; the pulp may undergo necrosis or restore viability. Based on the results obtained, further tactics are determined.
Types of alveolar bone fractures
Types of traumatic injuries:
- With a partial fracture, the configuration of the jaw does not change, only the integrity of the outer layer of the bone is damaged.
- With an incomplete fracture, all layers of bone substance are damaged, but the alveolar process does not change shape and does not change its anatomical position.
- With a complete fracture, the gap between the fragments of the jaw is clearly visible.
- The formation of a bone defect is characterized by the complete separation of a certain section of the alveolar process.
- A comminuted fracture is a serious injury, since several fragments are formed that can mix in different directions.
The most favorable fractures are non-displaced. With them, in most cases, it is possible to restore the jaw completely. The displacement is formed due to mechanical action, as well as muscle contraction, which stretches the bone fragments in different directions.
Clinical manifestations
The first sign of a fracture of the alveolar process is a sharp, severe pain. Usually its occurrence is associated with mechanical trauma. The patient cannot completely close his mouth, swallow and chew. The bite is broken.
Upon examination, a hematoma or rupture of soft tissue at the site of injury is usually detected. If the fracture is partial, the deformity may be mild. In complete displaced fractures, bone fragments can come out, breaking through the soft tissue.
The teeth in the area of injury are usually mobile and dislocated. In most cases, severe bleeding is observed.
If a child is injured, the consequences may be adverse. When the alveolar process, which contained the rudiments of permanent teeth, is fractured, they die, so the only solution in the future will be prosthetics.