Basic knowledge, abilities, skills, which are necessary for study themes ( intradisciplinary integration) .

P evious disciplines	Mastered skills
1.Normal anatomy.	To describe the structure of lower jaw, anatomy of masseters, muscles of neck, structure temporal-mandibular joint.
2.General surgery.	Plan of inspection of patient with a traumatic damage.
3. Biophysics.	Biomechanics of the maxillofacial system.
4. Pathological physiology.	Etiology and pathogeny of lower jaw fractures.
5.Topographical anatomy and operative surgery.	To interpret the topographical anatomy of maxillofacial area on the whole and of the lower jaw in particular. Principles of operative accesses to the different parts of maxillofacial area.
6.Renewal plastical surgery of maxillofacial area.	Consequences of traumatic damages of maxillofacial area in peace-time, the prevention of complications and inability of victims.
7.Surgical stomatology and maxillofacial surgery.	Basic questions of combined trauma, connection of organs and systems of maxillofacial area.

TASKs FOR INDividual WORK DURING PREPARATION TO Lesson.

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

Term	Definition
1. Fracture.	This is disorder of integrity of bone.
2. Main anatomical location types of mandible’s fracture.	Condylar coronoid Ramus Angle Body (molar and premolar areas) Symphysis and parasymphysis

4.2. Theoretical questions to lesson: 1. Types of surgical methods of treatment of non-bullet fractures of lower jaw. 2. Definition of a concept “direct and indirect osteosynthesis”. 3. Types of direct osteosynthesis, indications and contra-indications, method of operative interference. 4. Types of indirect osteosynthesis, indications and contra-indications, method of operative interference. 5. Modern methods of surgical treatment of non-bullet fractures of lower jaw (mini plates, transplantates, contour osteoplastics etc.). 6. Mistakes and complications during and after application of surgical methods of treatment of non-bullet fractures of lower jaw. 7. General (medicinal) treatment of non-bullet fractures of lower jaw.

4.3. Practical works (task) which are executed on lesson: 1. To master such methods. 1.1. To master basic methods of inspection of patient with the fractures of lower jaw in peace-time. 1.2. To conduct the additional methods of inspection of patient with the fracture of lower jaw in peace-time. 1.3. To conduct differential diagnostics of lower jaw’s body fracture with the fractures of other anatomic areas of lower jaw. 1.4. To fill the ambulatory medical card of patient with the lower jaw fracture. 1.5. To make a plan of treatment of patient with the lower jaw fracture in peace-time. 1.6. Rehabilitation of patient after the fracture of lower jaw.

5. TABLE OF CONTENTS OF THEME:

Complete fractures of the mandible can be divided according to their anatomical location into seven main types. These are:

1. Condylar

2. Coronoid

3. Ramus

4. Angle

5. Body (molar and premolar areas)

6. Symphysis and parasymphysis

7. Multiple and comminuted fractures

Fractures in each of these situations have clearly denned signs and symptoms which can be readily elicited even in cases of multiple injury.

Condylar fractures

These are the most common fractures of the mandible and are the ones most commonly missed on clinical examination. Condylar fractures may be unilateral or bilateral and they may either involve the joint compartment as intracapsular fractures or the condylar neck when they are regarded as extracapsular. The latter are the more common. The extracapsular fracture may exist with or without dislocation of the condylar head, and the upper fragment may either remain angulated on the lower portion of the ramus or be displaced medially or laterally. The commonest displacement is antero-medial owing to the direction of pull of the lateral pterygoid muscle, which is attached to the antero-medial aspect of the condylar head and also to the meniscus of the temporo-mandibular joint.

In the immediate post-traumatic phase most fractures in the condylar region exhibit similar signs and symptoms.