Journal of Regional Section of Serbian Medical Association in Zajecar

Year 2008     Volumen 33     Number 3-4
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UDK 616.716.4-001.5-089 ISSN 0350-2899, 33(2008) br.3-4 p.94-97
Case report

Reliability of peak expiratory flow measurement
in pulmonary function estimation in childhood asthma

Goran Bjelogrlić (1), Vesna Stojanović Kamberović (2)



INTRODUCTION: Fractures of the mandible are due to the effect of direct or indirect force. They are localized in the region of the mandible neck, symphysis, ramus, body, angulus or alveolar extension. Fractures can be simple, double, multiple or comminuted. AIM OF WORK: Presentation of the diagnostic and therapeutic treatment of mandible angulus fracture along the adverse line of fracture. METHOD: The diagnosis was made on the basis of the anamnesis relating to the manner in which the injury was sustained and clinical and radiographic examinations (before and after treatment – X-ray AP and skull profile, examination and side X-ray of the mandible and orthopantomograph). The therapy was conservative (immobilization splints) and surgical (osteosynthesis by the use of a plate). RESULTS: The patient, aged 18, was treated for injury sustained in a fight in February 2008 in the Institute for ENT and MFS of the Clinical Centre of Serbia, Belgrade. By inspection of the injury a swelling of the lower third of the cheek to the left, of soft consistency by palpation and painful to the touch, was noticed. By intra-oral inspection a swelling and a haematoma of the mucous membrane to the left were found. Bimanual palpation of the mandible showed pathological mobility of bone fragments in the region of the angulus to the left. In March 2008, immobilization splints were placed and inter-maxillary elastic fixation applied. A check-up radiographic finding showed unsatisfactory position of bone fragments in the line of the fracture, in the projection of the impacted wisdom tooth (tooth 38), extending from the upper edge of the alveolar extension to the back and downwards, to the base of the mandible. Surgical reposition of the fragments and osteosynthesis was made, along with the extraction of the tooth 38. Satisfactory occlusion was achieved. CONCLUSION: The angulus of the mandible is one of the predilection places (1/5) of fracture of the mandible whereas the presence of the impacted wisdom tooth makes it even weaker. The direction of the fracture line is important as regards the dislocation of fragments and it determines the therapeutic modality of treatment with anatomic reposition of bone fragments.
Key words: fracture of the mandible, adverse line of fracture, therapy

Napomena: kompletan tekst rada na srpskom jeziku
Note: full text in Serbian
  Corresponding Address:
Goran Bjelogrlić
KC Srbije, Institut za ORL i MFH
Pasterova 2, 11000 Beograd

Paper received: 23.07.2008
Paper accepted: 20.11.2008
Published online: 26.01.2009
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