Bahan Bljr SGD KGD Lbm 1

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    Overview

    What is a broken jaw (mandibular fracture)?

    A broken jaw (mandibular fracture) is the second most common facial fracture in sports

    because of the anterior location on the skull. The mandible is the jawbone. Because the

    mandible is exposed and not covered by most protective devices, it is susceptible to injury.

    Symptoms

    What are the signs and symptoms of a broken jaw?

    The mandible usually fractures in more than one place and occurs on opposite sides of the

    midline of the jaw. These fractures can either be displaced (more severe with bone ends

    separated and moved apart) or nondisplaced (bone ends aligned).

    The signs and symptoms of a displaced broken jaw include:

    Gross deformity

    Malocclusion (teeth do not align when jaw is closed)

    Oral bleeding

    Paresthesia or anesthesia of lower lip andchin

    Changes in speech

    Swelling

    Bruising to the floor of the mouth

    Mucous membrane tears

    The signs and symptoms of a nondisplaced broken jaw include:

    Oral bleeding oozing between the teeth

    Point tenderness over the fracture site

    Pain on opening and closing the jaw

    Swelling

    Discoloration

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    Causes

    Who gets a broken jaw?

    A broken jaw is most often caused by a blow to the lower jaw from sports equipment (hockeystick, bat). Because of the length of a hockey stick and/or bat, it does not take as much force

    from the opponent swinging the equipment to create enough force to fracture the jawbone.

    Mountain biking is another sport with a high incidence of facial fractures. This type of injury

    occurs when the athlete goes over the handlebars and falls directly onto the lower jaw or chin

    hitting a hard surface.

    Fighting sports in which direct blows are delivered as part of the sport (boxing, mixed martial

    arts) also have a high incidence of jawbone fractures.

    Treatment

    What is the immediate treatment for a broken jaw?

    If a broken jaw is suspected, emergency services should immediately be called. Initial

    treatment should be focused on maintaining an open airway with the athlete in a sitting

    position with the athletes hands supporting the lower jaw. This position will allow the blood

    to flow forward and out of the mouth rather than back into the throat.

    Because the amount of force required to fracture the mandible is significant, care must be

    taken to evaluate the athlete for possible concussion and/or brain injury also.

    To determine if the athlete has any signs and symptoms ofconcussion, check for the

    following:

    Dizziness

    Headache

    Confusion Nausea

    Ringing in the ears

    Inability to answer simple questions

    If any of the above symptoms are present, assume that the athlete may also have a

    concussion. An unconscious athlete or an athlete with a suspected concussion should be

    placed on their side with head tilt and jaw support after the mouth has been cleared of any

    broken or dislodged teeth.

    The jaw can be immobilized using an ace bandage or roller gauze but care must be taken to

    ensure that the jaw is not displaced posteriorly which may compromise the airway. Thebandages can be wrapped under the chin and over the top of the head.

    http://www.sportsmd.com/Articles/id/22/cid/1/n/concussions_and_the_effects_on_athletes.aspxhttp://www.sportsmd.com/Articles/id/22/cid/1/n/concussions_and_the_effects_on_athletes.aspxhttp://www.sportsmd.com/Articles/id/22/cid/1/n/concussions_and_the_effects_on_athletes.aspxhttp://www.sportsmd.com/Articles/id/22/cid/1/n/concussions_and_the_effects_on_athletes.aspx
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    A crushed ice pack can be applied to the area to reduce the amount of swelling. However,

    care must be taken that the weight of the ice pack does not displace the fracture.

    More Information: Read aboutsports injury treatment using the P.R.I.C.E. principle-

    Protection, Rest, Icing, Compression, Elevation.

    Is surgery needed to repair a broken jaw?

    If the athlete has sustained a nondisplaced jawbone fracture, the healing can be managed

    conservatively with analgesia and rest. To allow the fracture to heal properly, the athlete

    should only eat soft foods for up to four weeks or as long as recommended by the treating

    physician.

    Most displaced jawbone fractures will require closed reduction and internal fixation for four

    to six weeks. While the athletes jaw is wired shut, the athlete should be consuming high -

    protein, high-carbohydrate liquid diets. It is normal for an athlete to lose between 5% and

    10% of his/her body weight during this time. If there is concern about the amount of weightlost, the athlete should consult with a nutritionist.

    When is it safe to return to sports after a broken jaw?

    Light activities such as stationary cycling, walking, and light resistance exercises can be

    performed during the time of fixation to maintain muscle tone. Care should be taken not to

    increase the heart rate to a level where increased oxygen is needed for the muscles because

    the athlete is only able to breathe through his/her nose and not able to breathe through his/her

    mouth to increase the oxygen uptake. It is recommended that the athlete should not return to

    contact or collision sports until one to two months after the jaw is unwired.

    If you suspect that you have a broken jaw (mandibular fracture), it is critical to seek the

    urgent consultation of a local sports injuries doctor for appropriate care. To locate a top

    doctor or physical therapist in your area, please visit ourFind a Sports Medicine Doctor or

    Physical Therapist Near You section.

    Related Articles

    Broken Nose (Nasal Fracture)

    Subdural Hematoma

    Orbital Blowout FractureTraumatic Brain Injury (TBI)

    References

    Anderson, M.K., Hall, S.J., & Martin, M. (2009). Foundations of Athletic Training:

    Prevention, Assessment, and Management. (3rd Ed). Lippincott Williams & Wilkins:

    Philadelphia, PA

    Bahr, R., & Maehlum S. (2004). Clinical Guide to Sports Injuries. Human Kinetics:

    Champaign, IL.

    http://www.sportsmd.com/SportsMD_Articles/id/347.aspxhttp://www.sportsmd.com/SportsMD_Articles/id/347.aspxhttp://www.sportsmd.com/SportsMD_Articles/id/347.aspxhttp://www.sportsmd.com/SportsMD_DoctorSearch/d/doctors.aspxhttp://www.sportsmd.com/SportsMD_DoctorSearch/d/doctors.aspxhttp://www.sportsmd.com/SportsMD_DoctorSearch/d/doctors.aspxhttp://www.sportsmd.com/SportsMD_DoctorSearch/d/doctors.aspxhttp://www.sportsmd.com/Articles/tabid/1010/id/25/Default.aspx?n=broken_nose_%28nasal_fracture%29http://www.sportsmd.com/Articles/id/7/n/subdural_hematoma.aspxhttp://www.sportsmd.com/Articles/id/26/n/orbital_blowout_fracture.aspxhttp://www.sportsmd.com/Articles/tabid/1010/id/28/Default.aspx?n=traumatic_brain_injury_%28tbi%29_the_high_price_athletes_pay_to_compete_in_high_risk_sportshttp://www.sportsmd.com/Articles/tabid/1010/id/28/Default.aspx?n=traumatic_brain_injury_%28tbi%29_the_high_price_athletes_pay_to_compete_in_high_risk_sportshttp://www.sportsmd.com/Articles/id/26/n/orbital_blowout_fracture.aspxhttp://www.sportsmd.com/Articles/id/7/n/subdural_hematoma.aspxhttp://www.sportsmd.com/Articles/tabid/1010/id/25/Default.aspx?n=broken_nose_%28nasal_fracture%29http://www.sportsmd.com/SportsMD_DoctorSearch/d/doctors.aspxhttp://www.sportsmd.com/SportsMD_DoctorSearch/d/doctors.aspxhttp://www.sportsmd.com/SportsMD_Articles/id/347.aspx
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    Assessment & management of facial trauma injuries

    Facial trauma can present some of the most challenging injuries that prehospital care

    providers are called on to manage. Although most injuries to the face arent life-threatening,

    some may compromise the patients airway or result in significant hemorrhage requiring the

    providers immediate attention.

    Facial trauma may also be associated with other injuries that place the patients life in

    jeopardy. Finally, these injuries may be disfiguring, which may distract the novice provider

    from recognizing and addressing more serious conditions.

    Mechanisms of InjuryAlthough injuries to the face are mostly the result of blunt trauma, they may also result from

    penetrating trauma. The most common causes of blunt trauma to the face are motor vehicle

    crashes and assaults. During a crash, an occupant may strike their face on hard surfaces inside

    the vehicle, such as the steering wheel, dashboard or windshield, or on the roadway if theyreejected from the vehicle.

    Assaults, another common cause of injuries, occur when the face is punched by a fist or

    struck by an object. A minority of these injuries result from stab, gunshot or shotgun wounds.

    Assessment: Primary SurveyThe primary survey is a rapid assessment of vital functions to identify life-threatening

    conditions. The typical approach for performing the primary survey is through the standard

    ABCsairway, breathing and circulationdisability and exposure (A-B-C-D-E).

    Airway & breathing: The primary survey begins with an assessment of airway patency. Whenthe provider first sees the patient, numerous clues may point toward an inadequate airway.

    When lying in a supine position, an unconscious patient is at risk for airway obstruction from

    the tongue as it relaxes and falls back to block the airway. Noisy breathing, namely gurgling

    or high-pitched noises, indicates partial airway obstruction. The airway may be compromise