Signs and treatment of jaw dislocation
Dislocated jaw - the phenomenon not rare. All the bones of the skull are connected still. The only movable structure is a mandible. It is attached to the temporal bone with the temporomandibular joint. What is a dislocated jaw? In fact, this displacement of the heads of the lower jaw from its natural position. The reason can be any sudden movement of the person or external impacts leading to violation of the integrity of the joint.
The main types of injury
If we talk about the nature of the damage, the experts distinguish the following types of traumatic damage to the bone joints:
- Unilateral dislocation of the mandible due to the modification of the joint on one side only. Symptomatically manifests itself in the form of symmetry breaking in the lower face, which is rejected in the intact side, and the mouth is completely closed. This injury is quite rare.
- The diagnosis of bilateral damage is set up by injury to both joints. Clinic of this pathology is quite typical - the movement of the jaw apparatus of violated, and this, in turn, leads to the failure of the process of chewing, swallowing and talking. The patient is not able to fully close my mouth.
The nature of shear injury is divided into:
- Anterior dislocations of the lower jaw - in this case, the head is pushed forward, they are diagnosed in the majority of such injuries.
- Posterior dislocation of the head of the bone in the joint is shifted to the rear region. This injury is much rarer and usually appears in combination with a fracture process).
Dislocation can still be divided into complete, when the bone structure constituting the joint is not closed, and incomplete when the bone structure may be partially closed. In the latter case, traumatic injury is still referred to as "subluxation". The presence or absence of damage to surrounding muscle tissue, blood vessels or nerve endings, dislocation of the temporomandibular joint may be complicated or uncomplicated. On the basis of the frequency of this injury can be primary or recurrent (habitual).
The pathogenesis of the development of dislocation
The reason for the development of the front view of the dislocation is mainly different types of problems of the jaw joint. This can be attributed to the violation of the integrity of its constituent parts or deformation only interarticular disk. To this disease can cause the problem with the lower jaw, such as the inability for various reasons molars. Expertsindicate that the development of trauma contributes to the following factors:
- uncontrollable vomiting or retching leading to razevaya mouth;
- excessive yawning or screaming, the dislocation can also occur;
- in the provision of health care, e.g. at the time of tooth extraction, sensing the gastrointestinal tract, in case of intubation of the patient; when providing intensive care, for example, Allergy, or at the time of introduction of anesthesia, and so on.
Damage to the joint of the lower jaw can be due to an injury. Depending on the point of application of the traumatic exposure, may develop different damage:
- In the event of impact to the center is lowered chin develops bilateral anterior dislocation.
- Kick with left or right side will cause a one-sided trauma with the affected area on the side on which the blow fell.
The cause of back sprains do not differ from above described. In the case of injury this injury develops when a blow to the chin and a slight retraction of the jaw. In this case, the nomination of the head between the mastoid region of the temporal bone and fossa of the mandible. In fact, it is now in the area of the anterior wall of the auditory turn.
The result is even greater pressure trauma complicated by injury of the external auditory progress, and in the presence of increasing for various reasons the tongue (macroglossia) leads to disruption of breathing due to the tongue.
In the case of subluxation (partial dislocation), the shift can occur in two planes: lower and upper. Most often it is the so-called habitual dislocation of the jaw. As he develops?
- Discocephalinae subluxation is characterized by a shift of the upper region of the joint anteriorly with the involvement of intra-articular disk.
- The manifestation discountismo subluxation of the jaw just slides off the disc. Thus there is a characteristic crunch. It occurs due to the bending / unbending of the disc itself.
Signs of a jaw injury
In the formation of victim injury in addition to quite severe pain feels a click, which occurs in the joint. Immediately after that fine mouth he had to close not able. And not only because the child or adult will disturb the pain, but because the jaw is not in place as a result of displacement. The angle and direction of its shift is largelydepending on the nature of the injury. In the case of unilateral dislocation of the lower jaw to be skewed, which will lead to the diction, and the patient will not be able to chew and swallow. The result can be profuse salivation. This is the acute form of injury.
In the case where medical assistance in the required amount in time is not provided, is formed habitual, or, as it is called, chronic dislocation of the jaw. What is its danger? Irreversible changes of the tendons and muscle tissue of the joint, which leads to the inability to hold jaw apparatus in an anatomically correct position, even if carried out reduction. That is, it becomes unstable, and any sudden movement of the head of the mandible just POPs out of the joint capsule.
Especially dangerous in this respect, the subluxation of this joint. This is due to the fact that the clinical picture of the damage is smoothed, and the characteristics of dislocated jaw practically does not occur. In the end the patient just does not apply to the relevant institution for the purposes of treatment. The consequence of this injury may be a violation of the functioning of the lower jaw and the need for more complex therapies.
The diagnosis will help to put symptoms and clinical data obtained during the inspection and survey of the patient. To confirm the hypothesis by using x-ray examination of the lower jaw in two basic projections.
Specifics of first aid
The first thing you need to know - it is impossible to straighten the injured jaw even cats. The patient must immediately deliver to the casualty Department or emergency room for diagnosis and provide quality medical care. However, how can we ease the pain and reduce the unpleasant symptoms that are characteristic for this injury? Let's look at the highlights:
- The lower jaw can be fixed (tie). For this purpose a shawl or a scarf.
- A little take out painful sensations attached to the trauma place a cold compress, such as ice cubes.
- Receive pain medication in this case does not make sense in view of their low efficiency in such injury. More complex and effective drugs will be prescribed by a doctor.
Principles of treatment of sprains
The dislocated jaw of any complexity involves the treatment in a specialized hospital. To reduce the resulting defect can traumatologist or orthopedist. In view of the painful medical procedures surgery is performed under local anesthesia or General anesthesia. Consider the basic methods of correction of this dislocation:
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- Therapy by the method of Hippocrates involves special grip (the thumb presses on the bone of the lower jaw and the rest at the chin, smooth motion lifting it up) is achieved by relaxing the masticatory muscles. Then advance the jaw up and back. This leads to the restoration of the head in the anatomically correct position. However, the treatment is not over. The patient will put a special sling pressure bandage to the area of the lower jaw, which he will wear for about a week. Also during this period, it is not recommended to eat solid foods.
- The method of Brahmana-Gershuni more simple and takes very little time. Runs as in the oral cavity and on the outside. In both cases, on the surface of the lower jaw with your fingers grope the coronoid processes. Is the pressure on them in the plane down and back, which leads to the restoration of the integrity of the joint.
- Popescu method used in old dislocations, especially when another treatment has failed or other therapies could not be used for a variety of reasons. In this case anesthesia is required. During the correction of the dislocation in the field of permanent teeth are fixed cotton-gauze swabs. Further in the rearward and upward pressure is made on the chin, which leads to the restoration of the integrity of the jaw joints. If this does not help, surgery is performed.
At the risk of re-dislocation is recommended after reduction of the lower jaw some time to wear special orthopedic braces that are installed on the teeth.
They are both removable and non-removable. It is important to remember that timely treatment to the doctor will help correctly and competently to restore the dislocated joint and quickly return to normal, normal life.