Middle Third and Maxillofacial Fractures

Vocabulary flashcards covering diagnostic terminology, anatomical classifications, and surgical principles of middle third and maxillofacial fractures.

1. Le Fort Ill fracture is the same as

a) Craniofacial dysjunction

b) Guerrin's fracture

c) Pyramidal fracture

d) None of the above

1) A

2. Which of the following is not included in the

   Glassgow coma scale

a) Eye opening

b) Motor response

c) Verbal response

d) Pupil size

2) D

3. CSF rhinorrhea is found in:

a) Frontal bone structure

b) Zygomatico maxillary fracture

c) Naso ethmoidal fracture

d) Condylar fracture

3) C

4. A 35-year-old man with a Lefort III fracture

complains of blood tinged watery discharge from

his nose 2 days after the trauma. CT scan confirms

NOE fracture as well.

A) What investigation is most confirmatory for

detecting CSF leak

a) CT scan

b) MRI Scan

c) Presence of Glucose in the fluid

d) Presence of transferrin beta

4A) D

4. A 35-year-old man with a Lefort III fracture

complains of blood tinged watery discharge from

his nose 2 days after the trauma. CT scan confirms

NOE fracture as well.

B) The most common complication of CSF rhinorrhea is

a) Brain herniation

b) Blindness

c) Ascending Meningitis

d) Cavernous sinus thrombosis

4B) C

5. After fracture of middle cranial foramen there is epiphora this is due to damage of:

a) Ciliary ganglion

b) Greater palatine nerve

c) Infraorbital nerve

d) None of the above

5) D

6. The first step in management of head injury is:

a) Secure airway

b) I.V. mannitol

c) I.V. dexamethasone

d) Blood transfusion

6) A

7. Which of the following is not a feature of Le Fort Il fracture:

a) Enophthalmos

b) Malocclusion

c) Paraesthesia

d) CSF rhinorrhea

7) A

8. Gillis approach for reduction of zygomatic fractures is done through

a) Temporal fossa

b) Intra temporal fossa

c) Infra orbital fossa

d) All of the above

8) A

9. Guerin fracture is:

a) Maxillary fracture

b) Maxillary and zygomatic fracture

c) Maxillary and nasal bone fracture

d) Nasal bone fracture only

9) A

10. A fracture of eye by a ping pong boll is:

a) Blow out fracture

b) Orbital fracture

c) Blow in fracture

d) Compound fracture

10) A

11. "Panda facies" is commonly seen after

a) Le fort I fractures

b) Le fort II fractures

c) Mandible fractures

d) None of the above

11) B

12. Walsham's forceps are used to:

a) Remove teeth

b) Remove root

c) Clamp blood vessels

d) Reduce nasal bone fractures

12) D

13. A patient is in shock with gross comminuted

fracture, immediate treatment is to give:

a) Normal saline

b) Ringer’s lactate solution

c) Whole blood

d) Plasma expanders

13) B

14. Forceps used for maxillary fracture disimpaction

a) Rowe's

b) Bristows

c) Ashs

d) Walshams

14) A

Guérin's Sign

Ecchymosis observed in the region of the greater palatine foramen, characteristic of a Le Fort I maxillary fracture.

Hanging Drop Sign

A radiographic appearance seen in the maxillary sinus on a Waters (occipitomental) projection representing herniation of orbital contents in an orbital blowout fracture.

Floating Maxilla

A clinical presentation in Le Fort I fractures where the entire tooth-bearing maxillary complex moves as a single separated unit.

Moon Face Appearance

The distinctive facial ballooning caused by extensive soft tissue edema over the middle third of the face in Le Fort II and Le Fort III fractures.

Whitehead's Varnish

An antiseptic and hemostatic compound used on gauze packing to arrest hemorrhage originating from bone.

Traumatic Telecanthus

An abnormal lateral displacement of the inner canthi resulting in an increased intercanthal distance ($35\text{--}40\,\text{mm}$, compared to the normal $25\,\text{mm}$), typical of naso-orbito-ethmoidal (NOE) complex injuries.

Hooding of the Eyes

A clinical sign in Le Fort III fractures where the loss of support from Lockwood's suspensory ligament (due to a fracture above Whitnall's tubercle) causes the upper eyelid to descend with the globe.

Dautry Procedure

A surgical procedure for chronic TMJ subluxation in which the zygomatic arch is down-fractured and positioned downward in front of the condyle to block dislocation.

Compression Osteosynthesis

A rigid fixation technique employing bicortical screws to apply interfragmentary axial compression, promoting primary bone healing and preventing non-union.

Distraction Osteogenesis

A biological bone lengthening method based on Ilizarov's principle of tension-stress, where gradual traction stimulates regenerate bone formation and concurrent soft-tissue histogenesis.

Latency Period (Distraction Osteogenesis)

The initial post-osteotomy delay before activating traction, typically lasting $5\text{--}7\,\text{days}$ in adults but reduced to $0\text{--}2\,\text{days}$ in infants to prevent premature consolidation.

Regenerate Bone

The immature, newly forming bone matrix produced in the gap between distracted bone segments during the active distraction phase.

Antimongoloid Slant

Downward displacement of the lateral palpebral canthus seen in Le Fort III fractures resulting from inferior displacement of the fractured zygoma.