Surgical treatment of comminuted mandible fracture involving simplification with miniplates: Report of two cases

Authors

DOI:

https://doi.org/10.33448/rsd-v9i12.11398

Keywords:

Fracture fixation internal; Jaw fixation techniques; Fractures comminuted.

Abstract

Comminuted mandible fractures (CMF) are fractures that have multiple fracture lines resulting in several bone fragments. Among the forms of treatment for this type of fracture, open reduction with rigid internal fixation (RIF) seems to be the best option. This paper aims to report two cases of comminuted mandibular fracture treated by open reduction, simplification, and rigid internal fixation. In both cases, the fracture was simplified with 1.5mm miniplates and after the anatomy was restored, a 2.4mm reconstruction plate and bicortical anchor screws were installed. This type of approach provides stable occlusion, reconstruction of the mandibular anatomy and the absence of loose fragments that could progress to infection. It is concluded that the open reduction and the RIF of comminuted fractures using the principle of simplification optimizes the results and reduces complications.

References

Abreu, M.-E.-R., Viegas, V.-N., Ibrahim, D., Valiati, R., Heitz, C., & Pagnoncelli, R.-M. (2009). Treatment of comminuted mandibular fractures: A critical review. Med Oral Patol Oral Cir Bucal., 5.

Alpert, B., Tiwana, P. S., & Kushner, G. M. (2009). Management of Comminuted Fractures of the Mandible. Oral and Maxillofacial Surgery Clinics of North America, 21(2), 185–192. https://doi.org/10.1016/j.coms.2008.12.002.

Cavalcante Pita Neto, I., Martins Pereira Lucena Franco, J., Drumont Ramos Santana, M., Melo Teixeira Batista, H., Costa Studart Soares, E., Gomes de Alencar Gondim, D., Lucchesi Sandrini, F. A., de Abreu, L. C., & Miller Reis Rodrigues, L. (2015). Simplification on The Reduction Of Comminuted Mandibular Fractures For Stable Internal Fixation. International Archives of Medicine. https://doi.org/10.3823/1728.

Chrcanovic, B. R. (2013). Open versus closed reduction: Comminuted mandibular fractures. Oral and Maxillofacial Surgery, 17(2), 95–104. https://doi.org/10.1007/s10006-012-0349-2.

Ellis, E., Muniz, O., & Anand, K. (2003). Treatment considerations for comminuted mandibular fractures. Journal of Oral and Maxillofacial Surgery, 61(8), 861–870. https://doi.org/10.1016/S0278-2391(03)00249-0.

Finn, R. A. (1996). Treatment of comminuted mandibular fractures by closed reduction. Journal of Oral and Maxillofacial Surgery, 54(3), 320–327. https://doi.org/10.1016/S0278-2391(96)90753-3.

Futran, N. D. (2008). Management of comminuted mandible fractures. Operative Techniques in Otolaryngology-Head and Neck Surgery, 19(2), 113–116. https://doi.org/10.1016/j.otot.2008.04.005.

Haug, R. H. (1989). Management of low-caliber, low-velocity gunshot wounds of the maxillofacial region. Journal of Oral and Maxillofacial Surgery, 47(11), 1192–1196. https://doi.org/10.1016/0278-2391(89)90012-8.

Kanno, T., Karino, M., Yoshino, A., Koike, T., Tatsumi, H., Tsunematsu, K., Nariai, Y., Ide, T., Bai, Y., Dong, Q. N., & Sekine, J. (2017). Computer-assisted secondary reconstruction of mandibular continuity defects using non-vascularized iliac crest bone graft following oral cancer resection. Journal of Hard Tissue Biology, 26(4), 386–392. Scopus. https://doi.org/10.2485/jhtb.26.386.

Kazanjian, V. H. (1942). An outline of the treatment of extensive comminuted fractures of the mandible. American Journal of Orthodontics and Oral Surgery, 28(5), B265–B274. https://doi.org/10.1016/S0096-6347(42)90504-0.

Koshy, J. C., Feldman, E. M., Chike-Obi, C. J., & Bullocks, J. M. (2010). Pearls of Mandibular Trauma Management. Seminars in Plastic Surgery, 24(4), 357–374. https://doi.org/10.1055/s-0030-1269765.

Lee, K., Yoon, K., Park, K.-S., Cheong, J., Shin, J., Bae, J., Ko, I., & Park, H. (2014). Treatment of extensive comminuted mandibular fracture between both mandibular angles with bilateral condylar fractures using a reconstruction plate: A case report. Journal of the Korean Association of Oral and Maxillofacial Surgeons, 40(3), 135. https://doi.org/10.5125/jkaoms.2014.40.3.135.

Li, Z., & Li, Z.-B. (2011). Clinical characteristics and treatment of multiple site comminuted mandible fractures. Journal of Cranio-Maxillofacial Surgery, 39(4), 296–299. https://doi.org/10.1016/j.jcms.2010.04.009.

Ma, J., Ma, L., Wang, Z., Zhu, X., & Wang, W. (2017). The use of 3D-printed titanium mesh tray in treating complex comminuted mandibular fractures. Medicine, 96(27). https://doi.org/10.1097/MD.0000000000007250.

Mathog, R. H., Toma, V., Clayman, L., & Wolf, S. (2000). Nonunion of the mandible: An analysis of contributing factors. Journal of Oral and Maxillofacial Surgery: Official Journal of the American Association of Oral and Maxillofacial Surgeons, 58(7), 746–752; discussion 752-753. https://doi.org/10.1053/joms.2000.7258.

Motamedi, M. H. K. (2011). Management of firearm injuries to the facial skeleton: Outcomes from early primary intervention. Journal of Emergencies, Trauma and Shock, 4(2), 212–216. https://doi.org/10.4103/0974-2700.82208.

Olate, S., Vásquez, B., Sandoval, C., Vasconcellos, A., Alister, J. P., & del Sol, M. (2019). Histological Analysis of Bone Repair in Mandibular Body Osteotomy Using Internal Fixation System in Three Different Gaps without Bone Graft in an Animal Model. BioMed Research International, 2019. https://doi.org/10.1155/2019/8043510.

ORIF, reconstruction plate for Body, complex. ([s.d.]). site name. Recuperado 12 de outubro de 2020, de https://surgeryreference.aofoundation.org/cmf/trauma/mandible/body-complex/orif-reconstruction-plate.

Pereira A.S. et al. (2018). Metodologia da pesquisa científica. [e-book]. Santa Maria. Ed. UAB/NTE/UFSM. Recuperado de: em: https://repositorio.ufsm.br/bitstream/handle/1/15824/Lic_Computacao_Metodologia-Pesquisa-Cientifica.pdf?sequence=1.

Principles of Internal Fixation of the Craniomaxillofacial Skeleton: Trauma and Othognathic Surgery | Joachim Prein, Michael Ehrenfeld, Paul N. Manson | download. ([s.d.]). Recuperado 22 de outubro de 2020, de https://b-ok.lat/book/2879960/b0043e?regionChanged=&redirect=19477797.

Rana, M., Warraich, R., Rashad, A., von See, C., Channar, K. A., Rana, M., Stoetzer, M., & Gellrich, N.-C. (2014). Management of comminuted but continuous mandible defects after gunshot injuries. Injury, 45(1), 206–211. https://doi.org/10.1016/j.injury.2012.09.021.

Schenkel, J. S., Obwegeser, J., Zemann, W., Rostetter, C., Tandon, R., & Metzler, P. (2014). Outcome of Comminuted Mandibular Fracture Repair Using an Intraoral Approach for Osteosynthesis: The Journal of Craniofacial Surgery, 25(6), 2033–2037. https://doi.org/10.1097/SCS.0000000000001103.

Smith, B. R., & Johnson, J. V. (1993). Rigid fixation of comminute

d mandibular fractures. Journal of Oral and Maxillofacial Surgery: Official Journal of the American Association of Oral and Maxillofacial Surgeons, 51(12), 1320–1326. https://doi.org/10.1016/s0278-2391(10)80135-1.

Smith, Brian R, & Teenier, T. J. (1996). Treatment of comminuted mandibular fractures by open reduction and rigid internal fixation. Journal of Oral and Maxillofacial Surgery, 54(3), 328–331. https://doi.org/10.1016/S0278-2391(96)90754-5.

Sukegawa, S., Kanno, T., Masui, M., Sukegawa-Takahashi, Y., Kishimoto, T., Sato, A., & Furuki, Y. (2019). A retrospective comparative study of mandibular fracture treatment with internal fixation using reconstruction plate versus miniplates. Journal of Cranio-Maxillofacial Surgery, 47(8), 1175–1180. https://doi.org/10.1016/j.jcms.2018.09.025.

Zellweger, R. (2007). Maxillofacial fractures. ANZ Journal of Surgery, 77(8), 613. https://doi.org/10.1111/j.1445-2197.2007.04205.x.

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Published

28/12/2020

How to Cite

MENESES-SANTOS, D.; OLIVEIRA, M. M. M. .; SOL, I. .; RODRIGUES, C. M. de C.; LIMA, F. G. G. P.; SILVA, C. J.; BATISTA, J. . D.; SILVA, M. C. P. da . Surgical treatment of comminuted mandible fracture involving simplification with miniplates: Report of two cases. Research, Society and Development, [S. l.], v. 9, n. 12, p. e43991211398, 2020. DOI: 10.33448/rsd-v9i12.11398. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/11398. Acesso em: 12 nov. 2024.

Issue

Vol. 9 No. 12

Section

Health Sciences

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Copyright (c) 2020 Daniela Meneses-Santos; Mirlany Mendes Maciel Oliveira; Izabella Sol; Cristóvão Marcondes de Castro Rodrigues; Felipe Gomes Gonçalves Peres Lima; Claudia Jordão Silva; Jonas Dantas Batista; Marcelo Caetano Parreira da Silva

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