Conservative surgical treatment of multiple fractures of the face after a fall
DOI:
https://doi.org/10.33448/rsd-v11i2.25639Keywords:
Fractures, bone; Therapeutics; Treatment outcome; Mouth rehabilitation.Abstract
Facial fractures are a public health problem due to the need for specialized care, adequate environment and financial resources. They have different causes, and sports, work, traffic accidents and falls stand out as the main ones, being the same related to age, gender of the patient and direction of the trauma. This paper aims to report the clinical case of a male patient who fell 4.5 meters high, pushing his face against the edges of a swimming pool. Attended at the Maria Aparecida Pedrossian University Hospital, requiring outpatient and surgical care for the treatment of multiple facial fractures. The initial physical examination showed edema in the middle and lower thirds of the face, preserved visual acuity and ocular motility, mobility in the parasymphysis, laceration in the lower lip, marked mobility in dental elements, fragments of exposed oral bone tissue in the premaxilla region, absence of altered teeth and mandibular movements. Computed tomography showed a comminuted fracture in the anterior maxilla, bilateral fracture of the condyle and fracture of the mandibular parasymphysis on the left side. Thus, the treatment of choice was surgery under general anesthesia for placement of the Erich bar and maxillomandibular block, reduction and fixation of anterior mandible fractures and removal of bone fragments and unsupported teeth in the maxillary region. In the postoperative controls, the patient remained without complaints after the blockage was removed, with preserved mandibular movements and return to masticatory functions. Six months after the trauma, the patient is fully rehabilitated.
References
Batstone, M. D., Monsour, F. N., Pattel, P., Lynham, A. 2007. The patterns of facial injury suffered by patients in road traffic accidents: a case controlled study. International Journal of Surgery. 5: 250-4.
Carvalho, M. F., Herreo, R. K. R., Moreira, D. R., Urbano, E. S., Reher, P. 2010. Princípio de Atendimento Hospitalar em Cirurgia Buco-MaxiloFacial. Revista Cirurgia Traumatologia Buco-Maxilo-Facial, Camaragibe. 10(4): 79-84.
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.
D’avila. S., Barbosa, K. G. N., Bernardino, I. M., Nobrega, L. M., Bento, P. M., Ferreira, E. F. 2015. Facial Trauma Among Victims of Terrestrial Transport Accidents. Brazil Journal Otorhinolaryngoly. Rio de Janeiro. 82(3): 314-320.
Gaudêncio, T. G., Leão, G. de M. 2013. A Epidemiologia do Traumatismo Crânio- Encefálico: Um Levantamento Bibliográfico no Brasil. Revista Neurociências. 21(3), 427–434. 2013, v.21, 8261.
Gaetti-Jardim, E. C., Silva, H. C. L., Pereira, T. T. M., Masocatto, D. C., Oliveira, M. M., Mendonça, J. C. G. 2014. Tratamento de fratura complexa de terço médio de face associada a ferimento extenso. Archives of Health Investigation. 3(3):1-7.
Goodday RH. Management of fractures of the mandibular body and symphysis. 2013. Oral and Maxillofacial Surgery Clinics of North America. 25(4):601-16. doi: 10.1016/j.coms.2013.07.002.
Hayward, J., Scott, R. A. 1993. Fractures of mandibular condyle. Journal of Oral and Maxillofacial Surgery. 1:57-61.
Hupp, J. R., Ellis III, E., Tucker, M. R. 2015. Cirurgia Oral e Maxilofacial Contemporânea. 6ª ed. Rio de Janeiro: Elsevier; 2015.
Joshi, U. M., Ramdurg, S., Saikar, S., Patil, S., Shah, K. 2018. Brain Injuries and Facial Fractures: A Prospective Study of Incidence of Head Injury Associated with Maxillofacial Trauma. Journal of Maxillofacial and Oral Surgery. 17(4):531-537.
Lee, K. F., Wagner, L. K., Lee, Y. E., Suh, J. H., Lee, S. R. 1987. The impact-absorbing effects of facial fractures in closed-head injuries. An analysis of 210 patients. Journal of Neurosurgery. 66: 542- 7.
Leporace, A. A. F., Paulesini Júnior, W., Rapoport, A., E. C. B. C., Denardin, O. V. P. Estudo epidemiológico das fraturas mandibulares em hospital público da cidade de São Paulo. 2009. Revista do Colégio Brasileiro de Cirurgiões. 36(6): 472-477.
Manganello, L. C., Silva, A. A. F. 2002. Manidbular condylar fractures: classification and treatment. Revista Brasileira de Otorrinolaringologia. 68(5): 749-55.
Marcolino, P. R. B. 2014. Ressocialização das vítimas de fratura de face. Revista de Cirurgia e Traumatologia Buco-maxilo-facial. 14(3): 85-90.
Mendonça, J. C. G., Gaetti-Jardim, E. C., Manrique, G. R., Lopes, H. B., Freitas, G. P. 2013. Acesso Cirúrgico para Tratamento de Fraturas Mandibulares: Revisão de Literatura. Archives of Health Investigation. 2(2):19-23.
Meneses-Santos, D., Oliveira, M. M. M., Sol, I., Rodrigues, C. 2020. Tratamento cirúrgico de fratura cominutiva de mandíbula envolvendo simplificação com miniplacas: Relato de dois casos. Research, Society and Development. 9(12): e43991211398.
Miloro, M., Waite, P. D., Larsen, P. E., Ghali, G. E. 2016. Principios de cirurgia Bucomaxilofacial de Peterson. 3. ed. São Paulo: Santos Editora. 1344 p.
Minari, I. S., Figueiredo, C. M. B. F., Oliveira, J. C. S., Brandini, D. A., Bassi, A. P. F. 2020. Incidencia de multiplas fraturas faciais: estudo retrospective de 20 anos. Research, Society and Development. 9(8): e32795347.
Nahum, A. M. 1975. The biomechanics of maxillofacial trauma. Clinics in Plastic Surgery. 2(1):59-64.
O'Connor, R. C., Shakib, K., Brennan, P. A. 2015. Recent advances in the management of oral and maxillofacial trauma. British Journal of Oral and Maxillofacial Surgery. 53(10):913-21.
Pappachan, B., Alexander, M. (2012). Biomechanics of cranio-maxillofacial trauma. Journal of Maxillofacial and Oral Surgery. 11: 224-30.
Park, K. P., Lim, S. U., Kim, J. H., Chun, W. B., Shin, D. W., Kim, J. Y., Lee, H. (2015). Fracture patterns in the maxillofacial region: a four-year retrospective study. Journal of the Korean Association of Oral and Maxillofacial Surgery. 41: 306-16.
Péder, S. N. S., Rodriguez, E. A. S., Quinto, J. H. S., et al. 2020. Conservative treatment of mandibular condo fracture after firearm injury: inter-relationship between surgery and orthodontics. Orthodontic Science and Practice. 13(50):70-75.
Pereira, P. A. 2018. Metodologia da pesquisa científica [recurso eletrônico]. [et al.]. –1. ed. –Santa Maria, RS: UFSM, NTE.
Ribeiro, F. F., Hilgert, R., Soares, L. Y., Magnabosco Neto, A. E., Santangelo, A. G., Pacher, G. T., Fonseca, L. A. M. 2012. Estudo da prevalência de fraturas mandibulares em Joinville- SC. Revista Cirurgia e traumatologia buco-maxilo-facial. 12(3): 79-84.
Samieirad, S., Tohidi, E., Shahidi-Payam, A., Hashemipour, M. A., Abedini, A. 2015. Retrospective study maxillofacial fractures epidemiology and treatment plans in Southeast of Iran. Medicina Oral, Patologia Oral, Cirugia Bucal. 20: 729-36.
Schneider, D., Kämmerer, P. W., Schön, G., Dinu, C., Radloff, S., Bschorer, R. 2015. Etiology and injury patterns of maxillofacial fractures from the years 2010 to 2013 in Mecklenburg-Western Pomerania, Germany: A retrospective study of 409 patients. Journal of Cranio-Maxillofacial Surgery. 43(10):1948-51.
Silva, J. J. S., Lima, A. A. A., Dantas, T. B., Frota, M. H. A., Parente, R. V., Lucena, A. L. S. P. N. 2011. Fraturas de Mandíbula: Estudo Epidemiológico de 70 Casos. Revista Brasileira de Cirurgia Plástica. 26(4): 645-648.
Soares, L. O., Carvalho, B. C. S., Resende, R. G., Gomes, A. L. 2019. Tratamento fechado em fratura mandibular: parassinfisária e côndilar bilateral – relato de caso clínico. Revista da Faculdade de Odontologia, Universidade de Passo Fundo. 24(2): 292-298.
Souza, Y. D., Seco, A. J. L. G., Silva, J. C. L. Da., Pereira, K. F. S., & Jardim, E. C. G. (2021). Kaposi’s Sarcoma in an HIV and Covid-19 positive patient. Research, Society and Development.10(11), e19101119149.
Tanrikulu, R., Erol, B. 2001. Comparison of computed tomography with conventional radiography for midfacial fractures. Dentomaxillofacial Radiology. 30(3): 141-146.
Teles, I. C. M., Cruz, J. A., Parreira, D. R., Sousa, G. H. C., Curvina, M. M. G. 2016. Fratura panfacial: um relato de caso. Revista de Medicina e Saúde de Brasília. 5(3): 222-8.
Zaleckas, L., Pečiulienė, V., Gendvilienė, I., Pūrienė, A., Rimkuvienė, J. 2015. Prevalence and etiology of midfacial fractures: a study of 799 cases. Medicina (Kaunas). 51: 222- 7.
Zarpellon, A. T., Cruz, G. O. A., Gus, I. O., Moreira, G. H. G., Chamma, R. S., Masi, F. D. J. 2015. Revisão de 150 casos de fratura de mandíbula entre os anos de 2010 e 2013 no Hospital Universitário Cajuru - Curitiba, PR. Revista Brasileira Cirurgia Plástica. 30(4): 609-614.
Zhou, H., Lv, K., Yang, R., Li, Z., Li, Z. 2016. Mechanics in the Production of Mandibular Fractures: A Clinical, Retrospective Case-Control Study. PLoS One. 11: e0149553.
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Copyright (c) 2022 Heleninha dos Santos Galvão; Julio Cesar Leite da Silva; José Carlos Garcia de Mendonça; Gustavo Silva Pelissaro; Janayna Gomes Paiva-Oliveira; Francielly Thomas Figueiredo; Alana Oswaldina Gavioli Meira dos Santos; Athilla Arcari Santos; Ellen Cristina Gaetti-Jardim
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