The classification of fractures of the lower jaw distinguishes different degrees of severity of harm to health. This injury- is serious and dangerous, it must be properly treated. What can cause a fracture? What are its symptoms? And what treatment does a person with a fracture of the lower jaw require?
Fractures of the lower jaw are a dangerous injury, often accompanied by a concussion. A person can receive this injury as a result of a fight, a gunshot wound, an emergency, or a traffic accident.
This injury is related to medium degree severity of harm to health, in accordance with current legislation.
Most often in medical practice non-gunshot fractures of the lower jaw are recorded. Depending on the causes of occurrence, this type of fracture is divided into 2 categories:
Depending on the location of the damage, the following classification is distinguished:
There is also an open fracture - accompanied by bleeding, the presence of an open wound surface, and a closed fracture - without breaking the integrity skin.
The most severe type of fracture is considered to be bilateral, localized in two halves of the jaw.
In addition, traumatologists divide this injury into the following 2 categories:
With this injury, much attention is paid to diagnosis. Localization, severity of harm, influence choice therapeutic tactics, rehabilitation and recovery time for the patient.
Symptoms of a mandibular fracture are as follows:
A bilateral fracture of the lower jaw is accompanied by severe pain radiating to the area of the auricle. The pain syndrome is so severe that a person can lose consciousness and blood may flow from the ear. The injury is often accompanied by general weakness, nausea, vomiting and dizziness, which indicates a concomitant concussion!
One of the most typical signs is that the jaw clicks after a fracture; it is very difficult for the victim to talk and swallow. If such symptoms appear, it is necessary to competently provide assistance to the victim first aid and deliver it to you as soon as possible medical institution for diagnosis and prescribing further treatment.
Jaw fractures are classified as severe and extremely dangerous traumatic injuries. If appropriate measures are not taken in a timely manner, there is a high probability of developing the following undesirable complications:
The most dangerous consequence of this type of fracture is considered to be a purulent process that develops at the fracture site as a result of infection, which threatens meningitis and inflammation of bone tissue.
In addition, if you do not consult a doctor in time, the bone will not heal properly. As a result of this, they delve into cosmetic defects, speech disorders, difficulty eating, the patient’s quality of life is significantly reduced. Adequate timely treatment with subsequent rehabilitation allows you to avoid the development of most complications, in almost 90% of clinical cases!
If the lower jaw is fractured, the victim needs to quickly and competently provide first aid.
The success of subsequent treatment and the risk of adverse consequences will depend on the speed and accuracy of your actions!
The first step is to take care of preventing asphyxia and suffocation attacks. If a person is unconscious, he is turned over on his side and his tongue is fixed to avoid possible retraction.
Bleeding is stopped by squeezing the artery. The wound surface is firmly clamped with sterile gauze or a cotton swab. In case of a jaw fracture, a bandage is required to ensure immobilization and immobility. jaw apparatus. The headband can be made from any available materials, scarves, scarves, clothing sleeves, etc.
Next, in order to prevent the development of excessive swelling and the formation of hematomas, ice is applied to the damaged area, cold compress. This injury is almost always accompanied by severe pain, there is a high probability that the victim will fall into a state of painful shock. To prevent this, it is necessary to carry out anesthesia. Since the patient is unable to swallow normally, it is recommended to administer painkillers by injection!
For a patient with a fracture of the lower jaw, treatment is determined by a specialist individually after preliminary diagnosis; methods depend on the severity of the injury. First of all, the patient is given first aid. The specialist treats the wound surface, if necessary, tightens large vessels to stop bleeding, and installs a tracheal catheter to facilitate respiratory function.
After this, reposition is performed under local anesthesia. During this operation, the surgeon aligns the bone fragments in an anatomically correct position and fixes them to prevent re-displacement during the fusion process. Fixation is carried out using special staples, metal plates or extraoral structures.
In the most severe cases, plastic surgery, jaw prostheses are installed. After this, splinting is performed to immobilize the jaw during the recovery period. Applying a splint is a must in case of a fracture with associated displacement!
Patients are also prescribed a course drug therapy, which includes painkillers, antibiotics, anti-inflammatory drugs, the action of which helps prevent inflammation and infectious complications. With a purpose accelerated recovery and bone fusion, calcium-containing drugs, immunomodulators, chondroprotectors, and vitamins of group D are used. The duration of treatment, depending on the severity of the damage, ranges from a month to six months!
Since jaw fractures are always associated with disorders of chewing and swallowing functions, patients must follow a certain diet during the period of treatment and rehabilitation. At the initial therapeutic stages, patients are fed through a tube or a special straw.
After discharge during rehabilitation period The patient's diet should include the following dishes:
All food should have a liquid, puree-like consistency. Gradually, the menu includes vegetable and fruit purees, liquid porridge, pureed soups. At the same time, it is important that the patient’s diet is as varied as possible and includes all the necessary nutrients, otherwise the body may become depleted and the recovery process will be significantly delayed!
Rehabilitation after damage to the lower jaw plays an important role for successful recovery and prevention of dangerous consequences. At first, it is important to remain calm and avoid stress on the jaw apparatus, even speak better, as little as possible!
The following physiotherapeutic procedures are prescribed without fail, just a few days after the reposition:
Such procedures will help eliminate swelling and speed up the processes of callus formation and fracture healing.
To avoid infectious processes, the patient should pay increased attention to oral hygiene. After each meal, the mouth should be rinsed with antiseptic solutions. It is recommended to brush your teeth very thoroughly and at least 3 times a day.
You can’t do without therapeutic exercises. Rehabilitation begins with facial gymnastics and light self-massage of the facial muscles. After the patient’s condition has stabilized somewhat, the doctor will offer him a set of exercises aimed at developing the masticatory muscles. All exercises are very easy to perform. For example, very good results gives alternate clenching and unclenching of the jaw, clear, articulate pronunciation of different letters and sounds. Similar activities to achieve positive results It is recommended to carry out daily, 2-3 times throughout the day.
Gymnastics will allow you to quickly develop muscles and joints, fully restore speech and chewing function, and prevent the development of muscle contracture. The average duration of the rehabilitation period is about 2 months, after which the patient returns to his usual rhythm of life.
Competent, timely treatment of a fracture of the lower jaw in combination with comprehensive rehabilitation, subject to medical recommendations, will allow you to avoid dangerous complications, achieving full recovery all the main functions of the jaw apparatus. Self-medication in in this case is strictly contraindicated, the consequences can be the most unfavorable - from aesthetic defects in case of improper fusion to death in the case of purulent, infectious processes.
Injuries associated with damage to the jaw bones can lead to dangerous consequences for a person, so you should know about the symptoms and treatment of a jaw fracture, as well as how much does it clamp?
The pathology occurs due to a pronounced mechanical effect on the jaw, or due to other pathologies. There are partial bone lesions, complete, with displacement and others. Self-medication in cases of such injuries.
The main causes are divided into two types: pathological and traumatic.
Pathological, including anomalies of the anatomy of the jaw bones and the consequences of diseases of various etiologies:
Traumatic, including the consequences of falls, injuries, impacts, injuries, intense stress, road accidents and other conditions. Most often injuries are caused by:
The bones of the lower jaw are arranged in the shape of a horseshoe; it is easily crushed. The most common location of fractures is the area of the coronoid process, incisors, canines, and angles.
On upper jaw The weakest places in the structure are the closure with other bones. With minor injuries, as a rule, displacement occurs without the formation of fragments. In case of injuries received in the upper jaw area from the front, there is a risk of the fragment moving downwards and backwards. In case of falls or indirect impacts, there is also a risk of formation of fragments and their displacement to the base of the skull.
Classification of fractures according to the severity of the lesion:
Classification depending on the displacement of debris
Degrees complete fracture:
Treatment for a complete fracture is long and complex. An incomplete fracture is characterized by the presence of injured areas of the jaw with fragments; they, in turn, are not displaced.
Types of jaw bone injuries according to Lefort:
Based on location, fractures are divided into:
In relation to the place of impact, fractures are divided into direct (directly in the area of injury), indirect (in the opposite place).
Medical assistance on site, while awaiting qualified assistance, should be provided as quickly as possible. The basic rules are:
Any type of injury, both upper and lower jaw, is treated in a surgical hospital. In complicated cases, surgery is indicated.
Upon admission, the patient is anesthetized, a bandage is applied, diagnostics are performed (X-ray, CT, MRI), and bone structures are restored with sutures, staples, and plates. Implants are installed if it is not possible to put the patient’s bones together. Treatment includes antibiotic therapy and physiotherapy. The main methods of treatment are splinting and bypass surgery.
The bone fragments are adjusted using a special plastic device. In case of a fracture on one side of the face, the device will be applied on one side, in case of a complicated fracture - on both sides with the addition of special rings and hooks.
In case of injury to both jaws, complicated by the displacement of fragments, splints are applied to both jaws (two-jaw technique). The main goal of the method is to ensure the immobility of healing tissues. Treatment may take up to 2 months. Before the splints are removed, the patient is x-rayed to ensure tissue fusion.
The method is used in complicated cases. In this case, the injured bone fragments are fixed with special splints consisting of hooking loops and rubber intermaxillary rods (Tigerstedt splint).
The method allows, in addition to fixation, to reduce the load on the patient’s bones.
Even with a simple fracture, the patient experiences difficulty eating. Depending on the severity of the injury, the patient is selected a method of nutrition with auxiliary measures.
What can you eat if your jaw is damaged:
Important: the diet must compensate daily requirement patient in calories.
Video: how to eat properly if you have a broken jaw? Personal experience video blogger. You can also find other tips on his channel.
Without unpleasant consequences Jaw fractures, as a rule, do not go away. As a result of injuries, the following may occur:
Recovery after surgery or treatment includes physical therapy, physical therapy, oral hygiene.
Physical therapy is prescribed no earlier than a month after the splints are removed. It is important to restore chewing function, swallowing, and facial expressions.
Physiotherapy methods such as exposure are effective electromagnetic field different frequencies, pulsed magnetic therapy, ultraviolet irradiation, electrophoresis, applying ice, microwave therapy, paraffin therapy, infrared irradiation, massage of the collar area.
How long does it take for a fracture of the lower and upper jaw to heal?
In the absence of complications, such as traumatic osteomyelitis, inflammatory processes, milder fractures heal from 30 to 45 days. Injuries to the lower jaw are often more complex than to the upper jaw. Bone restoration can take up to 60 days.
Does it hurt to remove splints after a broken jaw?
The process of getting rid of splints is less painful than developing muscles and tissues after injury and immobilization. During rehabilitation, the muscles have become partially rigid; the patient will experience pain while eating, swallowing, and speaking.
How to determine a jaw fracture or bruise?
Common signs of injury are bruising, pain, swelling, and hematomas. Moreover, it is during a fracture that speech is difficult, the pain is more pronounced, the patient feels obvious weakness, even to the point of loss of consciousness. Accurate diagnosis Only the surgeon can determine it after x-rays.
How long are they in the hospital?
The duration of hospital treatment varies for different fractures. Complicated fractures, displaced, surgical intervention, will require a course inpatient treatment up to 4 weeks.
A jaw fracture is called a partial or complete defeat bones against the background of mechanical stress or under the influence of general pathological conditions. There are also double and triple types of fractures. The phenomenon itself is a serious injury, in which it is necessary to visit a doctor. What can be the consequences if the jaw is broken, what to do? It is unacceptable to treat such cases on your own, as this can cause many problems that will lead to tooth loss, as well as bone damage.
The following types are taken into account based on the reason:
Based on the degree of damage:
If you are injured, you should consult a doctor
The lower jaw is more prone to injury, because it is mobile. After receiving an injury, you must immediately consult a doctor for a proper examination of the lesion.
Signs of a fracture
Mobility of the jaw as a sign of a fracture
A fracture can be caused by the following reasons:
Sports as a cause of jaw fracture
When the jaw is damaged, displacement can occur in three types:
This plays a very important role in identifying the correct treatment regimen and choosing the equipment that will be used for correction. As a rule, in case of a displaced jaw fracture, treatment, symptoms, photo consequences, what to eat are special splints that are fixed on the teeth. The doctor collects bones with his hands. The person at this moment is under local or general anesthesia. Fragments can be fixed using nylon devices. The jaw can be attached with special metal spokes that are installed externally. After adjustment, the patient needs peace of mind with mandatory antimicrobial actions.
We consider in detail all aspects of such a complex facial injury as a displaced jaw fracture: treatment, symptoms, consequences, photos. What to eat is a separate question, because in postoperative period fixation of the jaws is necessary, the patient is given splints. And the consistency of the food for obvious reasons extremely liquid.
Patients must be prescribed a special diet. This must be done due to the fact that the patient will not be able to fully move his jaws.
The bones heal in at least a month, so during this period the patient will have to eat only liquid meals.
The consistency of all food should be puree, so a person should consume soups, broths, fruits and vegetables, ground through a meat grinder.
Qualified medical assistance can only be provided by medical workers. Before they arrive at the scene of the incident, the victim should be completely calm to ensure the immobility of the limbs. Analgesics can improve your health. It is worth remembering that it is impossible to treat a fracture of the lower and upper jaw at home. Symptoms, photos and signs can be found below.
The faster the treatment is carried out, the better it will be for the patient.
Therapeutic measures involve the following actions:
The upper jaw breaks much less frequently than the lower jaw.
The following signs are distinguished:
Patients often complain of severe nausea and severe pain. Vital functions are complicated. It is difficult for a person to talk, breathe, or eat. In parallel with jaw damage, patients are diagnosed with a concussion.
When providing first aid, the patient needs to restore breathing. All unnecessary objects are removed from the oral cavity. You can clearly see what a broken jaw looks like in the photo.
One of the main treatment methods is splinting. The event involves adjusting the fragments with displacement of the plastic device.
The type of action will depend on the type of damage:
Fixation for unilateral fracture
If plastic equipment is used, it is installed under the patient’s chin and a bandage is wrapped. However, this procedure is performed when assistance must be provided immediately in order for the victim to be taken to the emergency room.
To avoid unpleasant consequences, you need to seek professional help in time. The following complications are possible:
If necessary, surgery may be necessary to restore the affected areas of the face. For fractures light form and timely visit to the doctor, compliance with all his recommendations, mobility is restored within a month.
A mandibular fracture is a serious injury that most often affects men aged 20–40 years. As a result of such injury, partial or complete destruction of the integrity of the bone occurs. Fractures of the lower jaw are diagnosed much more often than injuries of the upper jaw.
This phenomenon is dangerous for human health, since it can provoke severe complications, including fatal outcome. To prevent undesirable consequences If you notice signs of a fracture of this only movable bone of the skull, you should immediately consult a doctor. In most cases, the patient’s life depends on the timely provision of assistance.
The lower jaw is a horseshoe-shaped unpaired skull bone designed for chewing food. The upper parts of its middle and two upward branches end in two processes: anterior (coronal) and posterior (condylar, or articular). The lower jaw has the following anatomical features:
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A jaw fracture is classified according to many criteria. According to the severity of violations of the integrity of the mandibular bone, they are divided into open and closed. In relation to the area of injury, they can be direct or indirect. Based on the line of the crack, this type of fracture is divided into single, double and multiple. The classification of mandibular injuries includes bilateral and unilateral varieties.
In addition, there are displaced fractures of the lower jaw bone fragments and without their displacement. The described type of injury is also classified into fractures of the canines, incisors, coronoid processes, as well as damage in the area of the angle, which is also called an angular fracture of the mandible.
An open fracture is characterized by displacement and protrusion of parts of the bone, as well as a violation of the integrity of the mucous membranes, muscles and skin. In this situation, there is a high probability of infection of the affected tissues. Often, in addition to the maxillofacial surgeon, a cosmetologist is involved in the treatment. The lower jaw is subject to this type of injury much more often than the upper jaw. With a closed type of fracture, only the bone is damaged, the integrity of the soft tissue is not compromised.
Fractures, depending on the location of the damage in relation to the point of application of the traumatic force, are classified into direct and indirect. In the first case, bone injury occurs directly at the specified point. Indirect damage occurs at some distance from it, in a more fragile area. Along with this, there is also a mixed type fracture, the formation of which involves a combination of the first two types.
Injuries to the jaw bones are treated in the department maxillofacial surgery. Treatment methods are classified into conservative (orthopedic) and surgical (osteosynthesis). If it is possible to do without surgery, reposition is performed. During this procedure, the bone is given an anatomical position, as a result of which the jaw grows together correctly. If it is not possible to use this method, use an elastic traction device.
Indications for osteosynthesis are multi-fragmented injuries, reconstructive surgery, neoplastic process in the area of injury, as well as injury to the condylar process, complicated by displacement of the articular head. During the procedure, damaged soft fabrics, bones are repositioned and immobilized using metal structures.
The diet during the recovery stage has characteristic features. Over a period of time, chewing function is impaired to varying degrees, so you should eat only liquid food. If it is impossible to chew and swallow food, the patient is prescribed food with a daily calorie content of 3000 to 4000 calories. In this case, food with the consistency of liquid cream enters the body through a tube.
In cases where the patient can chew and swallow food, he is shown a diet with the same nutritional value, however, the food has the consistency of thick sour cream. After discharge from the hospital, you need to eat fermented milk products, meat broths, drink strained juices and compotes from fresh fruits, berries and vegetables. Food should be varied.
Rehabilitation is a mandatory stage of treatment. Thanks to calcium electrophoresis, magnetic therapy and infrared irradiation, the injured jaw heals much faster. These methods are especially effective for angular fractures. Helps develop a joint therapeutic exercises. It includes regular facial exercises and self massage facial muscles. Average duration recovery period is 1.5–2 months.
At the same time, to avoid infection of damaged tissues, you should especially carefully monitor oral hygiene. After each meal it is necessary to rinse the mouth antiseptics. If you cannot fully open your mouth, you can rinse it with a straw.
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A mandibular fracture is a serious injury in which the linear integrity of the bone is disrupted. Most often, men aged 20 to 45 years are susceptible to damage.
A fracture can occur as a result of a fight ( strong blow into the lateral surface of the jaw), during road accidents, falls from a height, active sports, etc.
In the article you know what to do in case of a broken jaw and how to provide first aid, as well as subsequent treatment of the injury.
The lower jaw is an unpaired bone of the skull, the main function of which is to chew food. In appearance and shape the bone resembles a horseshoe. The structural features are as follows:
The classification of fractures is quite extensive.
Depending on the cause, fractures are divided into:
Depending on the location of the fracture line:
Separately, it is worth highlighting fracture-dislocation, in which a violation of the integrity of the bone is accompanied by a dislocation of the temporomandibular joint.
Depending on maintaining the integrity of the skin and soft tissues:
A double fracture is the presence of 2 fracture lines on one half of the lower jaw. Separately, there is a bilateral fracture of the lower jaw, in which there are fractures on its 2 halves. The combination of a double and bilateral fracture is called a multiple fracture.
Typically, a bilateral fracture occurs from a blow to the chin area from front to back. Characteristically, there is pain not only at the site of the impact, but also near the auricle.
To diagnose double and bilateral fractures, it is necessary mandatory radiography in 2 projections. Sometimes more may be required precise methods(For example, computed tomography). Used for treatment surgical methods, in particular, osteosynthesis - fastening bone fragments together using metal structures.
Most fractures of the lower jaw are accompanied by displacement of bone fragments. It occurs under the influence of 2 factors. On the one hand, this is the contraction and traction of the facial muscles, and on the other, the own gravity of the fragments. Muscles play a decisive role in displacement. The more muscles are attached to a bone fragment, the greater its displacement will be.
The displacement occurs in several directions: inward, outward and laterally (to the right or left side). Sometimes the displacement occurs along the length, that is, in the horizontal plane. This happens if the edges of the side fragments “overlap” each other. In practice, horizontal displacement of bone fragments is not so common.
To determine the type and degree of displacement, doctors refer patients to radiation methods studies (radiography, computed tomography, etc.). Not only the treatment tactics, but also the terms of rehabilitation, as well as the overall prognosis depend on the degree and type of displacement of fragments.
A fracture of the lower jaw can occur through several main mechanisms:
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Symptoms and clinical manifestations Fractures of the lower jaw are very diverse. They largely depend on the degree and severity of the fracture, the nature of the displacement, secondary complications etc. In general, a number of common symptoms can be identified:
Now you know how to determine if your jaw is broken.
The doctor may suspect a fracture of the lower jaw already during the questioning of the patient and examination. There are a number of symptoms, after checking which the doctor can make a preliminary conclusion about the nature of the fracture. However, for accurate diagnosis, radiation research methods are used, such as radiography, computed tomography and magnetic resonance imaging, etc. They provide comprehensive information about the location of the fracture, the presence of bone fragments, the degree and nature of the displacement, etc.
The outcome of a mandibular injury and further prognosis largely depend on the timeliness and correctness of first aid. It includes the following activities:
In case of serious injuries with complications, pain relief will require more strong drugs, for example, promedol. They are available in the arsenal of a doctor and an ambulance paramedic.
Treatment of mandibular fractures includes several stages:
Use of wire splints (splinting of the lower jaw)
Wire dental splints (Tigerstedt splints) are successfully used in clinical practice for more than 80 years. They were first developed by a dentist during the First World War.
Aluminum, bronze-aluminum or steel wire is used to make tires. Splinting for a jaw fracture is carried out under local anesthesia. The doctor bends the wire so that it follows the anatomical curves of the jaw, and then fixes it to the jaw. Removal of splints after a jaw fracture is also prescribed and carried out by a doctor!
Osteosynthesis
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This is a technique for fixing bones using metal structures. The indication for this operation is a comminuted fracture, reconstructive surgery, as well as the presence of a neoplastic process at the fracture site. During the operation, the soft tissue at the site of injury is exposed, reduction is carried out and the bones are fixed using metal plates, screws and screws. Bone suture
During the operation, several holes are made in the bone fragments, after which a wire (stainless steel or titanium) is inserted into them, which will perform a fixing function. Bone suture surgery is not performed for osteomyelitis and gunshot wound lower jaw.
Drug support
During the treatment of a broken jaw, it is necessary to use a number of medications:
Eating in patients with a broken lower jaw has many features. This is due to the fact that in the first time after injury, the chewing process is practically impossible, so food should be exclusively liquid.
There are several ways to feed such patients: through a nasogastric tube (the tube is inserted through the nasal passage directly into the stomach), through a straw, through a sippy cup.
There are 2 dietary tables for a fracture of the lower jaw:
After discharge from the hospital, be sure to include the following foods in your diet:
For cooking, it is very convenient to use a blender to give dishes the consistency of liquid puree. The grains of solid products should not be larger than semolina.
It is important to have enough essential nutrients in your daily diet. Not getting enough fat and protein from food can lead to exhaustion.
Full rehabilitation is possible only with strict adherence to all doctor’s instructions. First of all, this concerns complete oral care.
First of all, you need to develop the habit of frequently rinsing your mouth.. Moreover, this should be done not only after meals, but also between meals. Antiseptic solutions are used for rinsing: furacillin, chlorhexidine, soda solution, etc. For this purpose, it is convenient to use Esmarch's mug. It is filled with solution, hung near the washbasin and a rubber tube is attached to it.
ThisIt is equally important to clean your mouth of food debris with a toothpick. At least 2 times a day you need to carefully clean your mouth with hygienic toothpaste and a brush. After cleaning, gently massage the gums to improve local blood flow. An indicator of proper oral care is fresh breath and the absence of an unpleasant odor.
Physiotherapy
Physiotherapeutic treatment methods have been successfully used for many years in the rehabilitation period after a jaw fracture. They can eliminate swelling of soft tissues, reduce pain syndrome. To obtain a lasting effect, physiotherapy should be carried out in courses. Electrophoresis, UHF, magnetic therapy are used, infrared radiation, dry heat and others.
Therapeutic gymnastics
Therapeutic exercises can be performed in a standing, lying or sitting position, depending on the general well-being of the patient. You need to start with careful massaging of the facial muscles and exercises that strengthen the muscles of the shoulder girdle and neck. Gradually they move on to developing the chewing muscles. To do this, it is recommended to alternate between clenching and unclenching the jaws. It is better to start exercise therapy under the supervision of a specialist.
After a fracture of the lower jaw, complications often arise. They can develop either immediately after an injury or after some time.
The most common complications are:
In children, the structure of the lower jaw has some features:
Fractures of the lower jaw in children can occur as a result of fights, falls from a height, riding on a swing, etc. Boys are more susceptible to injury.
The clinical picture of fractures in children is practically no different from that in adults. The injury is accompanied by intense pain, soft tissue swelling, bleeding, and hematomas. Displacement of bone fragments in childhood is less pronounced.
Treatment tactics are chosen individually in each case. Non-invasive (conservative) fixation methods are more often used. During the rehabilitation period, it is very important to start exercise therapy in a timely manner in order to prevent the development of muscle contractures.
