Membaca Radiologi

Fraktur Wajah
Sandy S.S.

 Pemeriksaan

fisik = deteksi paling

sensitif

Rodriguez ED, Dorafshar AH, Manson PN. Facial fractures. In: Neligan PC, editor. Plastic surgery. 3rd
ed. New York: Elsevier-Saunders, 2013. p. 51.

Anatomi

Anatomi

Anatomi

Foto Roentgen
AP,

lateral, Waters, panoramik

C-spine clear?

Hollier Jr L. Kelley P. Soft tissue and skeletal injuries of the face. In: Thorne CH, Beasley RW, Aston SJ, Bartlett SP,
Gurtner GC, Spear SL, editor. Grabb & Smiths plastic surgery, 6 th ed. Philadelphia: Lippincott Williams & Wilkins,

Foto Roentgen
Identitas
Intensitas
Scope
Simetri
Fraktur

vs sutura vs lekuk pembuluh

darah
Dislokasi
Opasitas abnormal

AP

Head and soft tissues of face and neck. In: Mettler FA, editor. Essentials of radiology, 2 nd ed. Philadelphia: ElsevierSaunders, 2005. p. 13-42.

Lateral

Head and soft tissues of face and neck. In: Mettler FA, editor. Essentials of radiology, 2 nd ed. Philadelphia: ElsevierSaunders, 2005. p. 13-42.

Proyeksi Towne

Head and soft tissues of face and neck. In: Mettler FA, editor. Essentials of radiology, 2 nd ed. Philadelphia: ElsevierSaunders, 2005. p. 13-42.

Waters

Head and soft tissues of face and neck. In: Mettler FA, editor. Essentials of radiology, 2 nd ed. Philadelphia: Elsevier-

Panoramik

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.

Zygomatic arch
Maxillary sinus
Pterygoid plate
Nasal septum
Articular eminence
Glenoid fossa
Mandibular condyle
Sigmoid notch
Coronoid process
Mandibular ramus
Mandibular angle
Mandibular body
Mandibular canal
Mental foramen
Mandibular symphysis
Antegonial notch
Hyoid bone
Edentulous maxilla
Edentulous mandible

Fraktur nasal
Foto waters
(1) Fr nasal dg lateral displacement
(2) Medial displacement dari
proc.frontalis maxilla sin
(3) Lateral displacement dari
proc.frontalis maxilla dext
(4) Septum deviasi

Fraktur zygoma

Foto Waters:
(1)Fr rima orbita inferior
(2)Fr basis orbita
(3)Air-fluid level pd sinus maksilaris.

Foto Waters:
(1)Fr zygomaticofrontal
(2)Fr infraorbital
(3)Fr proc.zygomaticus
dari os temporal
(4)Gambaran radioopak
pd sinus maksilaris

Fraktur maksila
LeFort

I: garis
fraktur transversal
sedikit di atas akar
gigi dan melingkar
sehingga
memisahkan
maxilla menjadi 2
fragmen

Fraktur maksila
LeFort

II (pyramidal
fracture): mirip Le
Fort I pd bagian
lateral kiri dan kanan
makin ke medial
seperti piramid
melewati bagian
medial orbita dan
bertemu dg sisi
sebelahnya

Maxillary Fracture
LeFort

III (craniofacial
dysjunction):
melepaskan hub
antara
zygomaticofrontal
junction, nasofrontal
junction dan berlanjut
kedasar orbita kesisi
yang lain

(1)Fr horizontal dari midface

(2)Fr dinding medial dari sinus
maksilaris

(1)Garis fraktur yg menembus ddg

anterior dari sinus maksilaris, (2)
ddg posterior sinus maksilaris, dan
(3) maloklusi

(1)Fr
(2)Fr
(3)Fr
(4)Fr
(5)Fr

zygomaticofrontal bilateral
pros.frontalis
septum nasal
infraorbital bilateral
basis infraorbita dext

Garis fraktur yang melewati (1)

sinus frontalis, (2) ethmoid, (3)
sinus maksilaris dan (4)
pterygoid

Fraktur mandibula

1.
2.
3.
4.
5.
6.
7.

Condylar head or
intracapsular
fracture
Subcondylar
fracture
Coronoid fracture
Ramus fracture
Angle fracture
Body fracture
Symphysis
fracture

(1)Fr ramus mandibularis

komplit
(2)Fr angulus mandibularis
komplit

Fraktur mandibularis komplit

Fraktur proc.coronoideus komplit

Dislokasi TMJ

Foto Townes yang memperlihatkan

fraktur ramus mandibularis bilateral

Fraktur proc.condylaris

(1) fraktur parasymphisis mandibula

dan (2) fraktur ramus mandibula

Kasus
Fraktur linear dan fraktur depresi
Dislokasi TMJ

http://www.stritch.luc.edu/lumen/MedEd/Radio/curriculum
/Neurology/Head_trauma2.htm

http://images.radiopaedia.org/images/25042/e3f99d2b61
6c9e4c6b8920b6f2ff10.jpg

Kasus

Fraktur blow out orbita dg fraktur

dasar orbita

http://www.abstractsonline.com/EPosterViewer/MediaPreView.aspx?Ckey=%7B88399FA8DBD5-4C24-A400-AB053E4E6946%7D&Mkey=%7B22FDF1E0-BB98-47D9-B084-

CT scan
Fraktur
Jaringan

lunak
Hematoma
Air fluid level
Dinding orbita, otot ekstraokuler
3D:

orientasi keseluruhan

Rodriguez ED, Dorafshar AH, Manson PN. Facial fractures. In: Neligan PC, editor. Plastic surgery. 3rd ed. New
York: Elsevier-Saunders, 2013. p. 51.
Hollier Jr L. Kelley P. Soft tissue and skeletal injuries of the face. In: Thorne CH, Beasley RW, Aston SJ, Bartlett
SP, Gurtner GC, Spear SL, editor. Grabb & Smiths plastic surgery, 6th ed. Philadelphia: Lippincott Williams &

CT Scan
Densitas

fokal (perdarahan, ca,

logam)/ (edema, stroke)
Simetri pola gyrus
Midline shift
Ukuran dan posisi ventrikel
Sinus: cairan, massa
Pembengkakan jaringan lunak
Fraktur

http://w-radiology.com/skull-ct-anatomy.php

http://www.drstretch.net/graphics/reconstructive/ws_zygoma_Z_F_b.gif
http://img.medscape.com/pi/emed/ckb/otolaryngology/834279-1048674-

Hematoma sinus maksilaris dx

Diskontinuitas os maksilaris dx,
sphenoid dx

CT scan 3D

3D reconstruction
Fraktur panfasial

Terima kasih