jawsurgeryforums.com
General Category => Functional Surgery Questions => Topic started by: Lazlo on March 06, 2016, 06:31:04 AM
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he
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it's just simple fracture. easy to repair.
if it's just a zygomatch arch you do not need even plates.
if you can open your mouth fully, that means zygomatic arch will be a little flattened - it will appear after a several weeks. You will just have flattened side of the face
axamine your masseter muscle how it reacts when you open your mouth
do not chew, do not eat hard food. becuase your are gonna to pull down the zygomatic arch
you can wait max 2 weeks with such fracture. Later, it will be much harder to repair and sometimes not possible
but IMO you shoud have it put in right position before any surgery, after 12 weeks you will be able to have surgery - only if surgery procedures are not close to ION nerve... the nerve cannot be damaged during regeneration - it will be fatal
it's very simple fracture
no point to panic
go to hospital to repair it - it's just 15-30 minutes procedure
and go home and rest
BUT
since you have hypoathesia I think your maxilla is also broken . Probably it's simple fracture , you can try so called - CLOSE REDUCTION
ask about close reduction ...and be very careful for one month after that
OPEN REDUCTION means they have to access to your bones and install 1-2 plates
sometimes CLOSE REDUCTION is enough , if fracture is simple with minimal displacement
If you do not need any bone reposition - very unlikely, check at least you infraorbital canal. Now the infraorbital nerve can be compressed, if it stay like this it won't regain it's 100% function. The nerve can be compressed inside the orbit and on the ION foramen
PS Plastic Surgeon does not repair fractures, only maxillo-facial surgeon
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I corrected to 12 weeks of recovery after I realised you may have maxilla broken too
just ask your surgeon...
but you have to correct this before surgery
such simple fracture heals very fast without complications
but you have to wait minimum 12 weeks or more before you undergo next surgery
HOWEVER if you have LF3 in plans then the bone on one side is mobilised ;) sorry i know it's not funny
Regardless, If the surgeon is unavailable for next 3 months ,
you have to undergo reposition procedure , at least close reduction (if it's possible) and then you can wait 3-6 months for the planned surgery
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you are lucky you do not have double vision - the biggest problem after such fracture
even the ION will regenerate to 100% (very likely) if the surgeon remove compression by bone reposition
in the case of close reduction, observe your ION regeneration progress
, if the ION won't get 100% function after 6-7 months, then you have to explore your orbital floor to remove compression - which is also quite easy
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Sorry man :( Wish you well.
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Wow, that sucks, dude. Holy cow.
I'd let the injury heal fully then go ahead with surgery/reassess the situation. Your body is in shock/trauma right now and needs to heal first and foremost. Sounds like you need more info on the situation, though, too. Keep us updated.
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Lazlo where you exactly have numbness ? on the whole V2 area ? lower eyelid, whole cheek, side of the nose, upper lip ?
you can examine yourself , however since you have swelling on the eyelid probably it will be hard
on the infraorbital rim - above the eye you will feel step , clear step if yo have broken maxilla
mostly it's something in the middle under eye / or more close to nose where the fracture take place there - the weakest point
BTW I can't contact Sinn for 6 weeks . He is unavailable ?
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UPDATE:
Answer to Phantom post , which he deleted ...
because if fracture is simple / one piece / ZMC fracture then close reduction may be enough - in many cases enough, not all
The bone has 3-4 point of connection. A surgoen can "lock" the bone in cracks
When you have close reduction you need to be careful it's very easy to see if the bone is in right position
-lack of steps on infraorbital rim
-no flattenned cheek
You cant sleep on fractured side for at least one month even after open reduction. In close one it's restrticted
You can't eat hard food in first 2-4 weeks.
it's surgeon decision + patient plans. .You have to find optimum what is the best for you - if you have any choice. Sometimes only open reduction is possible
it;s very easy to protect yourself from sleeping on fractured side.
You take 2L Coca-Cole bottle. You fill it with water and cover with towel. The you put it near your back. If during sleep you try to turn over, then the body won't go in that way. What is interesting it's just additional secure.... because mostly you will have in subconscious that you can't do that
I DID never turn over during first month.
Instead of CocaCola 2L bottle better is bag with sand
Generally after such fracture for 66-% you will have installed plates, BUT
if the displacement is less than 2mm, probablynoone will touch the bone because it's too minimal - any manipulation will just damage more nerve
and isolated fracture on zygomatic arch is reduced without any plates - it's secued strongly by it shape and muscles - specific place
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so the maxilla is broken if you can feel that bone is moving
you will get full feeling back after min 12 weeks.
Fractures are less invasive than cutting bone...
Probably you have typical ZMC
zygomatico-maxillary-complex fracture
it goes through ION canal - this is why you have hypoasthesia
eventually it's due to broken orbital floor - where ION goes too
but if you can feel moving bon , then for 75% you have broken maxilla... the weakes point
here you have how such fracture looks like
http://pocketdentistry.com/wp-content/uploads/285/B9781455705542000162_f016-013-9781455705542.jpg
http://www.ibimapublishing.com/journals/PSIJ/2013/383486/ab.jpg
you can feel a bit maxilla bone when you put your finger above your uppaer teeth.. look how fractures looks like and you can just imagine when you can feel the bone steps
you can reach maxilla bone by pressing there above teeth.. press quite strongly and you will hear probably grinding sounds
You may also have fractured zygomatic arch with displacement
fractured maxilla, but without displacement or non-important displacement, but with fractured orbital floor
this is also possible
KEEP IN MIND THAT ION CANAL IS IN MAXILLARY BONE.. ZYGOMATIC BONE AND MAXILLARY BONE ARE CONNECTED.
BROKEN ZYGOMATIC BONE IS JUST GENERAL DESCRIPTION .. THE LINE OF FRACTURE MOSTLY GOES THROUGH MAXILLA IN MOST CASES
If i'm good guy , that means there is no karma... i have complications after my surgery :/ big problems
I'm now on examination phase
The most frightening is the fact i may have problem with hearing
i would give whole my money , house, car everything material to go back in time and to repair my fracture in proper time :/
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Lazlo i feel so f**kin sorry for you i'll hope it'll al settle soon
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Wow, and I thought I had bad luck.
I hope you will pull through all right, and I think you will. Someone as determined as you won't let some random thugs ruin all those plans you've been making.
In a few years it'll just be a story you can tell at parties.
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That's crazy, did you get jacked or the dudes were just looking to hurt random people?
I guess on the positive side it didn't happen AFTER you had surgery while you were healing. That's been a concern of mine... getting punched in the jaw post surgery. I haven't been in a fight for a few years but it could happen.
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My heart goes out to you, man! Make sure you get the best treatment possible.
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after surgery you should not go out to any parties etc for at least 3 months....
you should avoid any situation where you may get punched even accidently
untill you are in situation you want break your bone like me now...
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Yeah you're right Rico no late night nothing. And thanks Schrodingers Jaw!!! You're right I'm determined and won't let this get me down!!!!
Thanks everyone your support and kind words mean more than that of my Dad and friends cause you guys know what broken face bones are all about. I'll let you all know exactly what is broken and how the surgeon they assign is planning to fix it on Wednesday.
Yeah kjohn I was hit from behind then kicked on the ground all six pulled knives I didn't even really see what happened but I did catch a glimpse and saw two were Somalian and another was Arabic looking.
Look I'm of Indian descent born in Canada. But I think we're making a huge mistake letting all these immigrants in. They come from societies where violence is the norm. They don't have the safe coddled education and upbringing of most Canadians who are resolutely non violent. So I'm sorry f**k these people and I hope they all kill each other in a jihad. They broke my face for f**king 20 bucks and a cellphone. f**k them.
agreed. we must defend our values.
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Wow, those guys are all cowardly kunts. Wouldn't care if they all died of AIDS in the near future.
Keep your head up, you'll get through this. Sometimes chitty things just happen for no reason, but it is our character that comes through when we persevere through the BS.
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truth bro. it's funny how your opinion changes about things like cops and capital punishment when you're personally afflicted by assault or crime. Like I've seen a corrupt cop or two, but most of them are good people. And like the type of person who takes a malicious delight in kicking a person's head who is lying face down on the ground --i mean that type of s**t is pure evil. Through my hands I was yelling "Please stop hitting me I'm seriously hurt just take everything you want my cellphone is in my jacket please just take it and please stop hitting me" And instead he came back and before he took the cellphone from the jacket lying on the ground he kicked me close to 7 or 8 more times. He liked breaking someone's face. A person like that, the punishment should fit the crime so at the very least he needs his face broken and I would be okay with a person like that being put to death by a firing squad. I would have no remorse for issuing that sort of sentence.
And people are always blaming cops for excessive violence. With criminals like this, you can't be excessive enough. In these societies like many middle eastern countries and Africa it's just due to political and cultural circumstances they're bred to be violent like fighting dogs are bred to kill, and on top of that they are inculcated with stupid violent ideologies like Islam (which I'm sorry, I have read the Koran and it exhorts violence). So letting people like that into our society is just really really stupid. They don't look at human life the same way. Canada just let 20 000 Syrian "refugees" into Canada and there are TONS and TONS of Somali people all over the place here, like WTF???? It may be sad, but I'm just speaking a truth however unpleasant it may sound.
I mean, if you reach your mid-twenties or older and still believe that kicking someone random innocent person's head in for a cellphone is an okay thing to do, you are a lost cause and deserve everything you get. It's a pity you didn't have a piece on you to shown them what was up.
I'm in Canada too. I don't have anything against peaceful people who legally come here to assimilate, I just don't believe in giving people without proper background checks entry and then paying for them while they're here while ignoring our own homeless population.
Solution: eliminate all government assistance and they won't want to come, perform stringent background checks on those who do and make them follow the same procedure as every other European/American that wants to live here.
Libertarianism ftw.
Anyways, topic for another thread!
Get better soon man.
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That's terrible. The regulars who have been posting here together have a sort of unspoken bond together so you hate to see something like this happen to any of us. I always look forward to see everyone's progress here too so I certainly hope this doesn't derail your upcoming plans, this should be your year. Hope for the best and good luck.
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WOW. I don't have any ideas or suggestions, but just want to say how sorry I am!
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do not panic...this fracture is not complicated....easy
he has no diploplia that's the most important , the rest is simple
complicated it will be if he has for example damaged one of the joint - for 99% he hasn't.. in that case he would have terrible complications as mine after surgery - like problem with hearing function
believe me this fracture is very simple ...all he needs is just reduction with or without plates and good rest..it will heal without any problem very fast
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Yeah you're right Rico no late night nothing. And thanks Schrodingers Jaw!!! You're right I'm determined and won't let this get me down!!!!
Thanks everyone your support and kind words mean more than that of my Dad and friends cause you guys know what broken face bones are all about. I'll let you all know exactly what is broken and how the surgeon they assign is planning to fix it on Wednesday.
Yeah kjohn I was hit from behind then kicked on the ground all six pulled knives I didn't even really see what happened but I did catch a glimpse and saw two were Somalian and another was Arabic looking.
Look I'm of Indian descent born in Canada. But I think we're making a huge mistake letting all these immigrants in. They come from societies where violence is the norm. They don't have the safe coddled education and upbringing of most Canadians who are resolutely non violent. So I'm sorry f**k these people and I hope they all kill each other in a jihad. They broke my face for f**king 20 bucks and a cellphone. f**k them.
THAT SUCKS AND PISSES ME OFF SO MUCH. I hate punks that can't fight one on one and the fact they were immigrants make it even worse. Too bad you didnt have a gun. This is why if and when I get jaw surgery I'm not leaving the house for at least a month. Next to not being able to breath, getting hit or jumped or whatever is my next biggest fear cause you never know.
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Don't even get me started on MENA immigration. I live in Sweden and this country has transformed in the last 20 years like you wouldn't believe.
From one of the most affluent and well-functioning societies on the planet, to a ghetto ridden nightmare that feels like a satire of the political correctness dogma -only it's real.
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it's good to do running at night (sport).. when you run you seems to be taller and stronger. For example I run at nights and never been assulted
Muggers are afraid of exercised men... but at the same time try to not run into group.... take always the safiest way
you must learn also -- the same when you drive a car - to not look 1 metter ahead,, but 100 metters ahead in order to have time to recognise dangerous situation
if you walk down the street with head down - i'm just guessing - you have more chance to be attacked
this is how it works.. Muggers can't fight with strong people only with weaker ones
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Just how bad is it over there? I know Malmo is very bad but what about Stockholm?
Really sad
It's bad all over, there are so many migrants that authorities can't cope, and all the while the PC-fanatics are screaming that we need to accept more even if it means raising taxes to the highest they've ever been.
Like you said it's really sad. I gave up on this country last fall.
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if you do not run into unknown group of people, then you won't be attacked with knife, only with gun
Yes I'm from Poland... The crime statistics the same like in most countries
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I read this book (http://www.amazon.com/Alexander-Terrible-Horrible-Good-Very/dp/0689711735) to my kids sometimes. I'm willing to gift a copy if I get an address.
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Ok Lazlo tell me how is your face now... ? have they made Lisa Ann out of you with some gold plates inside ;) ?
To be honest I hope they will be able to do close reposition, or very limited open one with one micro-plate ... it's always better than having many incisions and those all plates inside, especially if you gonna have planned surgery soon.. but it depends on severity of trauma
BTW I bet the pain is like very minimal and only what is annoying is the reduced feeling and the fact it happened, right ;) ? ahh you also have little pain during eating .. probably zygomatic arch is much more damaged. mine just moved only about 2-3mm -- too minimal fracture to feel that
You are well informed about maxillo-facial stuff now, but imagine how easy is to overlooked such fracture if you do not have very obvious symptoms
i did not have even problem with eating nothing, my only symptoms were bruising and hypoathesia
and you should get slight fewer for 2 days
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You can upload your scans to a Google drive or Dropbox and share it with him.
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let us know. try to get surgery asap!
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what a stupid description you got
YOU HAVE PROBABLY TYPICAL ZMC FRACTURE (3POD) WITH DISPLACEMENT - one piece of bone
IF THERE IS ONE PIECE OF BONE ZYGOMATIC ARCH DOES NOT NEED TO BE FIXATED. EVEN IT OFTEN DOES NOT TO BE FIXATED WHEN YOU HAVE ISOLATED ZYGOMATIC FRACTURE
that bone is always broken in 3 places
orbita floor is always broken !!!
orbital floor is part of zygomatic bone
it's not worse.. it's like I suspected.
typical fracture
sygnificant displacement ? how many mm ? put your CT here I will tell you more
BUT NOTHING TO BE SCARE, IT'S TYPICAL SIMPLE FRACTURE
JUST THE DESCRIPTION YOU GOT IS LITTLE STRANGE
AVOID CORONAL APPROACH - IT'S NOT APPROACH FOR SUCH SIMPLE THINGS. It's devastating approach for you mind. Never do that on such simple problems. Its like shooting birds with cannon
Do typical close or open reposition / reduction
As i understand close reduction is possible (without plates) - so try it - but ask the doctor what about your canal if this will be good for your nerve decompression. After close reduction you have to be very careful for first month and observe yourself a few times a week. It's easy to teach patient how to look at it whether the bone is still in proper position. Even I can teach You :)
open reduction is more "safe / stable" but you have incisions plates bla bla bla ..then you have to put it out...sometimes you need incision on the lower eyelid - which heals 6 months - the most annoying incision. During healing your are is noticeable bigger ;) because the eyelid is pulled down by scar. There are pluses and minuses of those options. If fracture is simple - one piece of bone , i would choose close reduction (no incision, no plates) and observe myself being very careful
YOU CAN ALSO DO SOMETHING BETWEEN. CLOSE REDUCTION AND INSTALL ONE MINIPLATE (TO REMOVE) ON THE EYEBROW. Consider this.
The incision on the eyebrow heals very fastly, and the plate can be removed using local anasthetics
withou correction you will have what i had.. flattened face and nerve recovery failure
the stupid description you got make me thinking you should find another hospital / another doctor
It's easy to repair
but i wonder why she/he want to makes any incision on close reduction. Why not to screw in your cheek kind of thin lever to get easy manipulation
like this - however it's too short on this example - normally it's longer. Just imagine . It's simple physics
you will have just little dot on the cheek, which will heal in 3 weeks :)
(https://www2.aofoundation.org/AOFileServerSurgery/MyPortalFiles?FilePath=/Surgery/en/_img/surgery/05-RedFix/92/Zygoma/Z60_i520_S.gif)
show me CT i will tell you more...which approach is possible . Put all DICOM files, I will do 3D reconstruction, or do it yourself and give me some screenshots
Just compress (ZIP) DICOM folder from your CD and send me. Put on a server, or we can connect via Skype and you will send it in peer-to-peer mode. PM me
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Look at the example of the picture above
yes incision is not necessary .it's reserved for simpliest fracture with minimal to moderate displacement
How much you can open your mouth ? how many cm? sometimes this can be indicator how big displacement it is.. (if there is only one piecie of fractured bone)
If close reduction is possible, then a surgeon ( not all surgeons, just many do that) just screw in your cheek something to makes the bone easy to manipulate - he makes kinda lever
as it's visible on the picture in my previous post. It should be longer. Simple physics
However in the case of close reduction I would check if there is no strange fragments in the canal which may still compress the nerve after reduction, but it's rather rare. Generally you can always do CT again after 3 months to be sure if there is no compression on the nerve. BUT IF AFTER REDUCTION THE NERVE REGENERATES FASTLY, I MEAN WHEN YOU SEE IMPROVEMENT THAT MEANS IT;S OK :) If the nerve is only just compressed and you have still good feeling then 3-6 months and you will get 100% feeling
If you have quite good feeling then the nerve was just hit and compressed a little ... and moving the bone outside automatically do the decompression and that's all
As you see it depends on surgeon, which approach he preffers. So it' good to ask him about 2 possible options and what he thinks.
it's always about finding the optimal option for surgeon and a patient
I updated my post and added info about zygomatic arch fixation. Check again
Do the block with the bottle and towel as I described you earlier, but
for 99% you won't turn on your bad , it's on the subconscious level ;)
I will start to do it after about 6 weeks ;)
but secure yourself with kinda block in the bed near your back , that will protect you from sleeping on the affected side
ALWAYS MAKE A COPY OF ANY CD YOU GET FROM MEDICAL SERVICE.
I think quite good option is doing close reduction with one mini-plate on eyebrow. As your surgeon told you 40% for option without plates,, I would say rather 50% , then having mini-pplate on the eyebrow (to remove in few month) increase the number ,, I would say to 80-90% :)
but I do not see CT, I can't tell you more.
just 3 options I see without CT
- no incisions, no plates
- only one incision and one miniplate on eyebrow - easy to install, easy to remove, bone more secured
- incisions and 2-3 plates - i wouldn't do that if fracture is simple
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Lazlo,
Rico is doing good but having trouble with the language translation.
A "Closed" reduction of a fracture is one in which the surgeon manipulates the bone pieces without having to do surgery and open the skin to gain direct access to the fracture.
An "Open" reduction is when they have to do surgery and gain access to directly manipulate the bones or apply fixation internally.
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keep us posted!
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Ahh I see thanks for the translation Bobbit, very kind of both you and Rico to explain.
So I have a friend who is a young max fac who I never even thought about asking about all this (she's more of an acquaintance and I think quite new).
But here's interesting news. She said the craniofacial surgeon is not giving me the right advice. She said go to a good max fac. Any good max fac and she gave me a few names is well trained at fixing trauma to cheekbones and that it is indeed their "bread and butter". They routinely access the cheekbone if it fractures from inside the mouth and are able to fixate it with a metal plate. So while I have an appointment with another craniofacial doctor, and have sent Sinn my stuff (his reaction is going to probably be they don't know what the f**k they're doing in Toronto if they can't fix this), I'll hopefully try with a max fac as well. Hoping to get this fixed, behind me and healing for my real surgeries.
Keep in mind, the first "craniofacial" person you saw does not exhibit any evidence that she was ever actually trained in craniofacial surgery - - - . She may be. And she may know precisely what she is doing. And keep in mind, there is often more than one way to fix different fractures. Different surgeons will have different approaches to different problems. Does not mean any of them are wrong.
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Dr. Sinn to the rescue!!!!!!
I just got off the phone with him, he called my Dad personally. Now that's a f**king mensch!!!
He saw my CT said the bones are minimally displaced and just let them heal on their own. He saw that there were three fractures. Said the coronal incision is indeed the only way to fix it but it's not really necessary to fix it as often the bone overheals and will be stronger as a result and probably smooth over any displacement. Said it won't effect jaw surgery at all either.
He said the keen procedure won't be able to fix the displacement either since it's displaced differently in three places.
I just praise the Lord for Dr. Sinn, what a great surgeon and man. He's healing well from his surgery and is slowly slowly getting back into his practice. He really cares about his patients.
Alright. I think I'm going to take his advice. Will probably meet with one more surgeon Dr. Fialkov just to see what he says, but I think Dr. Sinn is right. He said if the cheekbone then needs to be changed with he does the second operation on me, he can always do that then.
LIFESAVER is all I have to say. What do you guys think?
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^ Glad to hear you got a good response. Best wishes and heal well!
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that's good.. so your bone moved no more than 1-2mm right ?
did you ask him about ION compression ?
hmm Sinn opinion is little .... hmm
PLEASE SHOW ME YOUR CT. I will check it myself
I was told also my bone was displaced minimally and I had significantly more flat cheek. but my displacement was about 2mm back and 3mm inward with some rotation
close/closed reduction is "close" no incision - just manipulating bone and set in proper position to lock the bone in cracks
open/opened reduction - do incisions and install plates
i'm sure about that and this is what I said before. I do not know why I was understood wrongly
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Dr. Sinn to the rescue!!!!!!
I just got off the phone with him, he called my Dad personally. Now that's a f**king mensch!!!
He saw my CT said the bones are minimally displaced and just let them heal on their own. He saw that there were three fractures. Said the coronal incision is indeed the only way to fix it but it's not really necessary to fix it as often the bone overheals and will be stronger as a result and probably smooth over any displacement. Said it won't effect jaw surgery at all either.
He said the keen procedure won't be able to fix the displacement either since it's displaced differently in three places.
I just praise the Lord for Dr. Sinn, what a great surgeon and man. He's healing well from his surgery and is slowly slowly getting back into his practice. He really cares about his patients.
Alright. I think I'm going to take his advice. Will probably meet with one more surgeon Dr. Fialkov just to see what he says, but I think Dr. Sinn is right. He said if the cheekbone then needs to be changed with he does the second operation on me, he can always do that then.
LIFESAVER is all I have to say. What do you guys think?
i wish i could visit dr. sinn and get surgery with him
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So your plans will not be interrupted now?
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I need Sinn advice too I have terrible problems after my surgery :/ noone an help me localy. Please PM me Lazlo
tell me how to send him that CT ? perhaps he will give me some advice
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I need Sinn advice too I have terrible problems after my surgery :/ noone an help me localy. Please PM me Lazlo
tell me how to send him that CT ? perhaps he will give me some advice
Send therm an email with a link to your Google drive or drop box. If they don't reply within a week, call them.
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I did it. I was told he is unavailable to April
So I wonder how Lazlo contacted him
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I did it. I was told he is unavailable to April
So I wonder how Lazlo contacted him
He'd seen him in person before. Thanks to earl25 sinn is inundated with emails.
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sorry rico
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You are right.
I checked my files. I see some errors there. I corrected them and it;s not so bad
just only zygomatic arch is strange.... the bottom of it. You can look at my files - You will see it .. that fragments of bone
i try to determine if this is important
and I'm little affraid that there is bone union after my infection
Sorry for my complaining in your thread. I'm creating new one ;)
PS I think Sinn is not right. If the displacement is >=2mm then, you shoud have reduction surgery, at least "closed" one. It's not so hard. You should check it in 2 or 3 hospitals... or go to another city. but really fast . You have to do it in this week. If I had your CT I would tell You what You need.
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LAZLO, REALLY IF YOU HAVE >= 2MM DISPLACEMENT, YOU MAY HAVE THE SAME PROBLEM AS MINE.
MY DISPLACEMENT WAS ABOUT 3MM, NOW I HAVE CORRECTED TO +2MM ;) 5mm movement. Slight overcorrection, but it does not look bad, better than flat / concaved cheek.
Oh this is interesting. I got this displacement on the cheek which always was almost flat (smaller than the other) So in my case it was visible. In your case it may not.
ASETHETIC NOT SO IMPORTANT, BUT YOU MAY HAVE COMPRESSED INFRAORBITAL NERVE BY THE BONE FRAGMENT
IF YOU LEAVE IT, YOU WILL HAVE PERMAMENT FEELING ISSUE ON VERY BIG FACE AREA.
IF YOU COULD GIVE ME CT I WOULD TELL YOU WHETHER YOU HAVE NERVE COMPRESSION. IT'S EASY TO CHECK
AND HOW BIG THE DISPLACEMENT IS - I HAVE EYE FOR THAT
if you have only no more than 2mm displacement and there is no compression, you realy may leave that not risking more damages to the nerve (during reposition) and unnecessary bigger surgery if you need opened reduction
Consider this.
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Firstly, very sorry to hear all this Lazlo! It's unfortunate that this is the price you have to pay for marxist "tolerance".
What I did want to address was Sinn's advice to leave it. Basically, I agree with Rico that you really need to ensure there aren't nerve problems. However, in any case, let's assume he's right. Why don't you then go with the KEEN option? 40% chance of success to make it like it was originally... 60% chance you're no worse off than doing nothing. And it's all intraoral.
Best of luck with it all.
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in close reposition he does not need any incision . He must take third advice. It gives 50% of chance that the bone won't back to wrong position
Good choice to try.. almost no surgery
I'm sure about that
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first of all, so sorry about what happened to your lazlo. what a scary situation that's made even more stressful considering you are pursuing major craniofacial surgeries! i hope you are recovering emotionally and pain free!
well, the two fractures are fairly clear and seem to have left a seemingly floating segment of the zygomatic arch. i think the third fracture looks more "hairline" in the sense that the bone doesn't appear to have moved but i can see a thin fracture all the way at the back by your ear.
obviously you are pursuing multiple opinions and these doctors know way more than me but as far as i know the cut for the dr. sinn/earl surgery is made right around where your first fracture is, kind of just past the malar prominence not too far down the zygoma. i was told by dr sinn that its hard to access the arch area via oral incision. but maybe your case is different!
whatever happens, i wish you the best of luck and I'm sure you will make smart and well informed decisions. also, you are in good hands with dr sinn for sure! as I'm sure you know, he is a top notch surgeon as well as a very kind man!
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and one more a bit clearer
Lazlo - -
Your nose has been broken - - right ? What is the plant to correct the deviated septum ?
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rhino eventually. my nose was never broken, and the surgeon said my septum is perfectly straight when I asked her the very same thing. weird, eh?
The film was then either taken at a non-orthogonal orientation to your facial axis - - or something else is weird with the imaging.
It sure looks like a dysfunctional nostril from the images. Do you breath normally if you block each nostril independently ?
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holy s**t. zygomatic arch is totalled... hmm and it's close to joint
you have to give me all dicom files.. put in drop box or write me your Skype login, I will find You
i will do 3D reconstruction for You and for me
on 3D problem is more visible
you can't have just closed reduction.. at least it won't give anything to your zygomatic arch...
or pehaps closed reduction + zygomatic arch repairing through skin incision close to facial nerve. But many surgeons do that approach
it seems like you mostly were kicked in the side of the face not directly to the cheek.
you have fractured both cheeks ? i see something unclear even on the other one
UPDATE: but to be honest displacement of the arch is not big, almost minimal. Hmm ...do you have still big functional problem ?
I would like to see whole CT to check your maxilla and ION canal , and generaly whole bone position. a few plane x-rays is not enough
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that's ok could you send me his name ? PM me I will ask him about my issue
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Lazlo I just saw this thread. Sucks man. Problem is the migrants who come to Canada. Legit scum of the earth. Don't give a f**k about anything.
My suggestion is.
Buy brass knuckles and carry them when walking alone at night. One punch in the face will really f**k up the fragile skull of a Somali.
Join a boxing gym and build up your bone density in your arms and knuckles, build up your cardio and strength.
Join a Krav Maga place to learn self defence
Avoid late night s**t like walking. But if you live downtown it kinda sucks. .
With s**t like this it honestly jsut bad luck. Problem is Somalis and Arabs usually chill in groups so you have to run away or really f**k one of them up so they back off. Being big also helps. If you look weak and defensless you're asking to get mugged. It's just the way it is.....
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Ya I live in the GTA area.
Whenever I'm waking alone at night I'm always looking around for ppl and stuff. Constantly ready. The days of ending a fight after knocking someone out is over, these days people really try to f**k you up. It's sad.
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Dude who gives a f**k if you're being racist. Stereotypes are true for a reason. Brown ppl on average don't create problems, neither do Asians, Latinos(in Canada) and whites. The sad truth is that most crime committed up here is by blacks and Somalis. I don't have studies to back this but my experience and my friends experience. Europe is a prime example.
The fact that Trudeau is also bringing in more Syrian migrants doesn't help. Most of these ppl can't assimilate and don't give a f**k about the way Canadians like to live. Not to mention that North America has become an emasculated p*ssy wiped society. That's another topic.
The best defence is the best offence. Too bad we don't have conceal and carry here.