Prijelomi donje čeljusti

Prijelomi donje čeljusti većinom su posljedica prometnih nesreća, napada, tučnjava i drugih oblika trauma u području lica. Prema mjestu nastanka, dijele se na prijelome tijela, simfize, kuta, uzlaznoga kraka donje čeljusti i, najčešće, prijelom kondilarnog nastavka. Prijelomi se u moderno doba većinom dijagnosticiraju radiološki, uz neizostavnu palpaciju i perkusiju. Razvoj moderne radiologije doveo je do modernih trodimenzionalnih CT uređaja koji prijelome rekonstruiraju i samim time pridonose odluci o odabiru vrste liječenja. Terapija se svodi na kirurško šiniranje i spajanje ulomaka, osim ako zdravstveno stanje ne dopušta opću anesteziju pacijenta. Tada se primjenjuje vanjska fiksacija (intermaksilarna fiksacija). Kirurških tehnika ima mnogo, razlikuju se od autora do autora, no većina se svodi na intraoperativno reponiranje ulomaka i njihovu fiksaciju vijcima ili pločicama. Komplikacije se pojavljuju, ali su one dugotrajne rijetkost. Liječe se uglavnom ponovnim otvaranjem kirurškog polja, čišćenjem rane, ponovnom epozicijom ulomaka i ponovnom fiksacijom. Ako kirurška terapija nije potrebna, liječi se fizikalnom terapijom, odnosno vježbom. Postoperativna njega svodi se na mirovanje i apstinenciju od sporta, odličnu higijenu usne šupljine, ispiranje otopinom klorheksidina i meku hranu. Nakon završene terapije i potpunog srastanja pacijenti se vraćaju normalnim životnim aktivnostima bez ikakvih ograničenja.Mandibular fractures are mostly the result of traffic accidents, assaults, fights and other forms of trauma to the facial area. According to the place of origin they are classified as fracture of the body, symphysis, angle, ramus and, the most common, fracture of the condylar process. In the modern era fractures are mostly diagnosed radiographically, with the inevitable palpation and percussion. The development of modern radiology has led to a modern three-dimensional CT device that breaks, reconstructs and thereby contributes to the decision in choosing the type of treatment. Therapy consists of surgical splinting and connecting fragments, unless the clinical condition of the patient does not allow general anesthesia, in which cases external fixation or maxillomandibular fixation (MMF) must be used. Surgical techniques differ from author to author, but most of them come down to the intraoperative repositioning of fragments and their fixation with screws or plates. Complications can occur, but they are usually not long-term. They are treated mainly by re-opening of the surgical field, cleaning of the wound, repositioning of fragments and by re-fixation. If surgical treatment is not needed, the fracture is treated with physical therapy and exercise. Post-operative care is reduced to bed rest and avoiding sports activities, as well as to proper oral hygiene, which includes rinsing with chlorhexidine solution and following a soft diet. After the therapy and complete healing, patients return to their normal daily life activities without any restrictions