Everyday Oral Surgery Basics of Trauma: Secondary Survey and Fracture Repair Principles (with Dr. Andrew Jenzer)
Mar 30, 2026
Dr. Andrew Jenzer, an oral and maxillofacial surgeon and trauma educator from North Carolina, reviews practical trauma fundamentals. He walks through secondary survey steps and systematic head-to-clavicles assessment. He breaks down fixation principles like rigid versus semi-rigid constructs, load-bearing versus load-sharing, and the role of locking screws. He flags orbital emergencies and key CT techniques.
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Do A Vertex-To-Clavicle Secondary Survey And Ignore The Obvious
- Perform a top-down, hands-on secondary survey: inspect and palpate from the vertex to clavicles and touch what you look at.
- Ignore the largest obvious injury and deliberately search for hidden fractures or C-spine issues.
CSF Leak Diagnosis Has Fast Clues But Slow Confirmation
- Battle sign or otorrhea can indicate basilar skull fracture and possible CSF leak.
- Beta-2 transferrin confirms CSF but takes days; halo test is unreliable; measure CSF glucose/chloride for quicker clues.
Assess NOE Injuries With Medial Canthal Distance And Bowstring Test
- Check medial canthal distance and perform bowstring test for NOE injuries and traumatic telecanthus.
- Markowitz-Manson classifies NOE: Type I intact tendon, Type II comminution with tendon attached, Type III tendon detached guiding repair.