Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Module 7 > ORAL SURG mandible fracture management > Flashcards

ORAL SURG mandible fracture management Flashcards

(86 cards)

Start Studying
1
Q

what are the 2 parts of the condyle?

A

head
neck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

where does the lateral pterygoid attach?

A

pterygoid fovea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what anatomical structure is behind the external oblique ridge?

A

ramus of the mandible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what anatomical structure is inferior the the external oblique ridge?

A

angle of the mandible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what foramen are found in the middle portion of the mandible?

A

lingual and mental

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

where does the mylohyoid muscle attach?

A

oblique line on the lingual surface of mandible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what part of the mandible contains teeth?

A

alveolar process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

where does the mentalis muscle attach?

A

mental tubercles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what exits through the mental foramen?

A

terminal branch of the IAN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

where is the mental foramen?

A

between apices of premolars

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

define a fracture?

A

a break or a breach in the continuity of normal anatomical structure of a bone by the application of excessive force resulting in 2 or more fragments of the involved bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

why does the mandible often break in more than 1 place?

A

due to its horseshoe shape

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what structure is a known point of weakness?

A

condylar neck (crumple zone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the aetiology of mandibular fractures?

A

assault
sporting injury
RTA
pathological

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what types of pathology predispose the mandible to fracture?

A

osteolytic lesions:
cysts
tumours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the 5 types of fractures seen in the mandible?

A

simple
compound
comminuted
greenstick
pathological

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

define a simple fracture?

A

undisplaced
overlying periosteum is intact
radiograph shows crack through cortical layer of bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

describe a compound fracture?

A

perforated through periosteum and often skin
presents externally
involving tooth socket

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

why do compound fractures predispose mandible to infection?

A

the fracture line runs through the PDL into the oral cavity, exposing mandible to the oral microbiota

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

describe a comminuted fracture?

A

fracture pattern has multiple fracture lines
bone broken to small fragments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

describe a greenstick fracture?

A

uncommon
outer cortices fracture and inner cortex flexes
no displacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

where are the sites in the mandible that can fracture?

A

dento-alveolar
condylar
coronoid
ramus
angle
body
parasymphysis
symphysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

where is the commonest area of fracture to the mandible?

A

condylar neck
angle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

why is the condyle known as the crumple zone?

A

instead of driving the condyle into the skull, it will break to prevent damage to the brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
why is the angle of the mandible a point of weakness?
the presence of erupted or partially erupted lower 8s
26
why is the parasymphysis a point of weakness?
root of the canine
27
in what direction does the coronoid process usually displace and why?
superiorly due to the temporalis point of attachment
28
what is the relevance of the muscles attached to the mandible and fractures?
dependent on the pattern of the fracture, the muscles can pull the fracture together or apart causing displacement causes significant pain
29
in what way do horizontally favourable fractures pull?
upwards
30
in what way do vertically favourable fractures pull?
laterally
31
list the muscles attached to the mandible which may affect the distraction of fracture
medial and lateral pterygoid temporalis masseter digastric geniohyoid genioglossus mylohyoid
32
what direction does the lateral pterygoid displace a condyle fracture?
anteriorly and medially
33
what direction does the temporalis, masseter and med. pterygoid displace a proximal segment fracture?
superiorly and medially
34
what direction does the digastric, geniohyoid, genioglossus and mylohyoid displace the distal segment fracture?
inferiorly and posterior
35
what factors determine the displacement of fractures?
pattern of fracture degree of comminution teeth in fracture line muscle pull
36
what makes a fracture unfavourable?
muscles pulling them apart
37
what is a bucket handle fracture?
seen in edentulous mandibles bilateral parasymphyseal fractures anterior segments pulled downwards and backwards
38
in a bucket handle fracture, what muscles pull the anterior segment downwards and backwards?
mylohyoid geniohyoid digastric genioglossus
39
what is a guardsman fracture of the mandible?
caused by a fall on the midpoint of the chin resulting in fracture of the symphysis as well as both condyles
40
what is a common finding of displaced fracture?
malocclusion
41
list the extraoral clinical features of mandible fractures?
pain swelling bruising trismus soft tissue injury: cut lip, dirt, tooth fragment otorrhoea external auditory meatus tear (may accompany condylar fractures) anaesthesia/ paraesthesia of the lip
42
list the intraoral clinical features seen with mandible fractures?
haematoma in FOM and buccal mucosa malocclusion tongue swelling gingival laceration mobility/ loss of teeth fractured teeth
43
what intraoral finding is pathognomic of a fractured mandible?
haematoma in FOM/ buccal mucosa (Coleman's sign)
44
what causes a parasymphyseal step deformity?
proximal segment displaced superiorly by muscle pull
45
what may be a sign of an undisplaced fracture?
small laceration in gingivae
46
what must be checked when suspicious of an undisplaced fracture?
mobility - if there is mobility the fracture will not heal
47
what are the ideal radiographic views for examination of mandible fractures?
DPT + PA mandible/ facial
48
when do mandibular fractures merit tx?
displacement (mobility noted) and malocclusion
49
what complication arise due to a delay in tx of mandibular fractures?
wound dehiscence infection exposure of hardware non-union or fibrous union
50
what time frame should mandibular fractures be treated within?
72 hours
51
what happens to a tooth involved in the line of a fracture?
it becomes non-vital needs endo tx
52
what are the 2 types of treatment for mandible fractures?
open technique closed technique
53
describe the open technique for treating mandibular fractures?
fracture margins are visualised intraorally or extraorally via an incision
54
why is the open technique preferred for mandible fractures?
the fracture is immobilised to allow a period of healing
55
describe the closed technique for treating mandibular fractures?
fracture margins are not directly visualised - no incision - intermaxillary fixation (wiring jaws together)
56
in the open technique, describe reduction?
aligns the bone ends anatomically recreates the normal anatomy
57
in the open technique, what is the purpose of fixation?
prevents movement of the bone whilst healing occurs
58
describe load bearing fixation in the open technique?
100% of the functional load is supported by the fixation e.g., 2 large plates
59
describe load sharing in the open technique?
the load is distributed between the hardware and the bone margins e.g., one upper boarder plate and arch bars
60
why do we want fixation in the open technique to be load bearing?
not replying on adjacent bone to hold 2 ends together
61
what are the 2 methods of fixation?
open closed (intermaxillary)
62
what is used for the open method of fixation?
mini-plates reconstruction plates compression plates (old fashioned) lag screws
63
what materials are used for closed intermaxillary fixation?
arch bars eyelet wires leonard buttons cast cap splints gunning splints
64
what are mini-plates used for and made from?
open fixation - made of titanium (they osseointegrate) - they do not get removed
65
when fixating an edentulous mandible, what material do you use?
gold reconstruction plates - very rigid
66
list the indications for closed reduction?
non-displaced favourable fractures grossly comminuted fractures significant loss of overlying soft tissue edentulous mandible fractures fractures in children coronoid process fractures undisplaced condylar fractures
67
what are the advantages of closed reduction?
inexpensive simple procedure no foreign body so reduced risk of infection
68
what are the disadvantages of closed reduction?
not absolutely stable prolonged period of IMF up to 6 weeks possible TMJ sequelae decreased oral intake possible pulmonary considerations (aspiration pneuomonia)
69
where do IMF screws engage?
labial cortex
70
what is a gunning splint?
used for edentulous fractures anterior teeth removed from denture for oral intake denture is wired in place for up to 6 weeks
71
what are indications for open reduction?
displaced unfavourable fractures multiple fractures edentulous displaced fractures bilateral displaced condylar fractures
72
what are the advantages of open reduction?
improved alignment and occlusion fracture immobilised avoid IMF low rate of malunion or non-union lower rate of infection
73
what are the disadvantages of open reduction?
morbidity of surgical procedure expensive hardware need for GA
74
what are Champy's principles?
miniplate osteosynthesis = placement of a plate along the so-called ideal line of osteosynthesis, thereby counteracting distraction forces that occur along the fracture line in the mandibular angle region, this line indicated that a plate may be placed either along or just below the oblique line of the mandible between the mental foramina, 2 plates are recommended below the apices of the teeth
75
why may extra-oral open reduction be used for edentulous mandible fractures?
to avoid stripping the periosteum as it is less vascular
76
what type of plates may you want to use for edentulous mandible fractures?
large reconstruction plates that are load bearing
77
what are complications of management of mandibular fractures?
non-union, fibrous union, mal-union altered occlusion distracted TMJ scars infection necrosis numb lip exposed plate
78
what are the 2 types of condylar fractures?
extra-capsular intra-capsular
79
describe an intra-capsular condyle fracture?
within the capsule, small fragments
80
describe an extra-capsular condylar fracture?
nearer the neck
81
how are condylar fractures usually treated?
soft diet and NSAIDs
82
what is TMJ effusion?
inflammation
83
what is the treatment for a displaced/ dislocated condylar fracture?
open reduction and internal fixation
84
how is a intracapsular condylar fracture treated?
closed approach
85
what is of concern with paediatric fractures?
tooth germs and condylar growth plates
86
how are paediatric fractures treated?
conservative management with splints

Module 7 (72 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions