Theme № 16. osteosynthesis, methods of fixing of fragments of bones of the facial skull. Achievements of native scientists, colleagues of chair.

1. ACTUALITY OF THEME. Knowledge of methods of a constant (medical) immobilization of fragments at damages of maxillofacial area will allow the doctor - stomatologist to organize and render rationally the qualified and specialized medical aid by the victim in a peace time, in a wartime and in extreme situations.

2. СONCRETE AIMS: 2.1. To analyze the indications and contraindications to application of an osteosynthesis and apparatus methods of treatment of cfractures ofjaws. 2.2. To explain principles of an osteosynthesis at fractures of jaws. 2.3. To offer the new approach in a choice of designs for surgical treatment of fractures of jaws. 2.4. To classify surgical methods of treatment of facial bones. 2.5. To treat the data of X-ray pictures of victims with fractures of facial bones. 2.6. To draw schemes, the schedule of application of surgical methods at treatment of fractures of mandible and maxilla. 2.7. To analyze possible complications at treatment of fractures of facial bones by surgical methods. 2.8. To make the plan of treatment of different types of fractures of facial bones by surgical methods.

BASE KNOWLEDGE, SKILLS, THE SKILLS NECESSARY FOR STUDYING OF THE THEME (interdisciplinary integration).

Names of the previous disciplines	The received skills
1. Normal anatomy.	To know a structure of bones of the face, anatomy of chewing muscles, muscles of a neck. To show places of an attachment of muscles to the jaws.
2. Topographical anatomy and operative surgery.	Topographical anatomy of maxillofacial area as a whole and bones of the face in particular. Principles operative admission to different areas of maxillofacial surgery.
3. General surgery.	To make the plan of examination of the patient with traumatic damage. To be able to survey correctly the patient and to fill up the medical documentation.
4. Traumatology.	To be able to use the main principles of treatment of fractures. To make the plan of surgical treatment of the victims with bone fractures of the face.
5. Orthopedic stomatology.	To know kinds of materials and designs which are applied for surgical treatment of victims with fractures of jaws.

TASKS FOR INDIVIDUAL WORK DURING PREPARATION FOR THE LESSON.

4.1. The list of basic terms, parameters, characteristic, which a student must master at preparation to lesson:

The term	Definition
1. Reduction.	This comparison отломков bones.
2. Fixing.	This fastening отломков in correct conditions.
3. Immobilization.	Deducing (removing) of body from function.
4. Оsteosynthesis	Surgical fixing of bones fragments.

4.2. Theoretical questions to the lesson: 1. Principles of treatment of a bones fracture. 2. Concept about constant or medical immobilization of bones of the face. 3. Kinds of fixing and pressing bandages which are applied in maxillofacial trauma. 4. Surgical methods of medical immobilization of fractures of jaws. 5. The combined methods medical immobilization of jaws fragments. 6. Medicaments method of treatment of victims with fractures of mandible and maxilla.

4.3. Practical works (task) which are executed on lesson: 1. Working off of algorithm of work with devices by Rudko and by Zbarsh. 2. Professional training on scheduling surgical treatment of victims with fractures of jaws.

5. TABLE OF CONTENTS OF THEME:

The methods of immobilization can be sum­marized as follows:

1.Osteosynthesis without intermaxillary fix­ation:

a)non-compression small plates;

b) compression plates;

c)miniplates;

d) lag screws;

e)resorbable plates and screws.

2. Intermaxillary fixation:

a)bonded brackets;

b) dental wiring: direct, eyelet;

c) arch bars;

d) cap splints.

3. Intermaxillary fixation with osteosynthesis:

a)transosseous wiring;

b) circumferential wiring;

c)external pin fixation;

d) bone clamps;

e)transfixation with Kirschner wires.