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PubMed1993

Pediatric mandibular fractures treated by rigid internal fixation.

Mandibular fractures in the pediatric patient population are relatively uncommon. These patients present with their own unique treatment requirements. Most fractures have been treated conservatively by dental splints. Closed reduction techniques with maxillomandibular fixation (MMF) in very young children can pose several concerns, including cooperation, compliance and adequate nutritional intake. Rigid internal fixation of unstable mandibular fractures using miniplates and screws circumvents the need for MMF and allows immediate jaw mobilization. At major pediatric trauma institutions, there has been an increasing trend toward the use of this treatment when open reduction is necessary. This article presents a report of a five-year-old child who presented with bilateral mandibular fractures and was treated by rigid internal fixation and immediate mandibular mobilization.

Bone Plates↗
PubMed2005

Fracture patterns and bone healing in recurrent mandibular fractures: a clinical study of 13 patients.

BACKGROUND: Recurrent fractures of the previously treated fractured mandible are rare. METHODS: In this retrospective study, 13 cases of repeated mandibular fractures were evaluated according to age, sex, cause, fracture localizations and patterns, treatment modalities, and complications. RESULTS: All of the patients were men, with a mean age of 27.5 years and 32 years for the first and the subsequent fractures, respectively. The mean time interval between fractures was 4.3 years. In 10 cases, the cause for the second fracture was an assault, with 90 percent related to alcohol intake. Angle, body, and parasymphysis region of the mandible were the most common sites to be involved in the first occasion. In 10 cases, an internal rigid fixation procedure was performed for the treatment. In the recurrent injuries, none of the fractures occurred at exactly the same anatomical site. Fractures were either in the neighboring side or the contralateral side of the previously healed area of mandible. On the second occasion, angle fractures were common and body and subcondylar fracture rates increased. At second presentation, the complication rate increased from 23.1 percent to 53.8 percent and most commonly involving malocclusion. CONCLUSIONS: This study showed that assault is the major etiologic factor for recurrent mandible fractures and that these fractures occur in different locations from the original injury. They necessitate a cautious approach for the prevention of unfavorable outcomes. Further retrospective clinical and experimental studies are necessary to elucidate the fracture patterns and bone-healing quality of these recurrent mandible fractures.

Adult↗
PubMed1995

[The use of hydroxyapatite with ultrahigh dispersity in the combined treatment of patients with mandibular fractures].

Altogether 125 patients with mandibular fractures of different localization were treated. Implantation of ultrahigh dispersed hydroxyapatite was included in the treatment schemes, both surgical and conservative, of 65 of these patients. Such implantations were found easy to perform, well tolerated by the patients, and causing no side effects. The incidence of complications in this group was by 6.78% lower than in controls treated by the traditional methods alone and by 7.16% lower than in all patients with mandibular fractures treated over a year. The mean disability period was reduced by 4.8 days when this preparation was used.

Biocompatible Materials↗
PubMed1985

Intraoral open reduction of mandibular fractures.

Experience with 31 mandibular fractures treated by intraoral open reduction techniques is reviewed and the techniques described. A 12.9% complication rate was experienced, no complication causing significant morbidity. Indications for intraoral open reduction are reviewed and the literature is discussed. The intraoral open reduction technique is a satisfactory treatment method for selected cases of fractures of the mandible.

Fracture Fixation↗
PubMed1981

Use of a dynamic mini-compression plate for the internal fixation of mandibular fractures.

Internal fixation for mandibular fractures can be simplified using dynamic mini-compression bone plates, frequently employed by orthopedic surgeons. These enable fragment immobilization without the usual intermaxillary fixations--arch bars, splints, and so on. They also allow better oral hygiene, early feedings, and short hospitalization. Complications and risk of infection appear to be minimal. The intraoperative steps are described.

Biomechanical Phenomena↗
PubMed2005

[The clinic study of internal-fixation of mandibular fracture with endoscope].

OBJECTIVE: To investigate effectiveness of internal-fixation in mandibular fracture through endoscope. METHODS: Use puncture internal-fixation under endoscope to treat 28 patients of fracture of mandibular angle, ramus and condyle. RESULTS: The 28 patients were restorated with occluding relation in good apposition. The healing of mandibular fracture was very good. CONCLUSIONS: The interal-fixation under endoscope is an effective way of treating fracture of mandibular angle, ramus and condyle, without facial scar and complication of facial nerve injury.

Adolescent↗
PubMed1997

Trends in the incidence and cause of sport-related mandibular fractures: a retrospective analysis.

PURPOSE: This study assessed changes in the incidence and causes of mandibular fractures occurring in innsbruck, Austria between 1984 and 1993. PATIENTS AND METHODS: Records from 712 patients sustaining 982 mandibular fractures were reviewed and analyzed according to age, sex, date of fracture, place of trauma, cause, anatomic site of fracture, and associated orofacial and craniocerebral injuries. RESULTS: Sports were the most common cause of mandibular fractures, accounting for 31.5% of the entire sample, followed by road traffic accidents (27.2%) and falls (20.8%). The yearly distribution of sport-related mandibular fractures showed an increase from 28.6% in 1984 to 1988 to 34.5% in 1989 to 1993. The major causative factor in sports-related mandibular fractures was skiing (55.3%), whereas cycling and soccer accounted for 25.4% and 8.9%, respectively. Significant changes in the occurrence of cycling-related mandibular fractures were observed, with an increase of 19.3% from 1984 to 1988 to 1989 to 1993, whereas skiing-related mandibular fractures showed a decrease of similar magnitude (19.5%). Sex distribution showed a male-to-female ratio of 2.5:1, with the percentage of females involved increasing. In cases of cycling-related accidents, there was a considerable prevalence of associated injuries (133.3 injuries per 100 mandibular fractures), with significantly higher rates of facial lacerations (73.2), tooth fractures (39), tooth luxations (24.4), and orbital fractures (3.7) than in the case of skiing-related injuries, whereas in patients sustaining mandibular fractures caused by soccer, mucosal lacerations, tooth luxations, and cerebral concussions were the only associated injuries found. CONCLUSIONS: The results of this study indicate a considerable change in the cause of mandibular fractures, showing that sporting injuries are becoming increasingly common. The high incidence of associated maxillofacial injuries in patients involved in skiing and cycling accidents may suggest an increasing need for preventive and protective measures.

Adolescent↗
PubMed1992

[Analysis of two kinds of method in the treatment of mandibular fracture].

In this paper, 27 cases of mandibular fracture with displaced fragment were divided into experiment group fixed by plate following AO principles and control group fixed by IMF. Through postoperative evaluation separately at the first, second, third month by means of X-ray, occlusal analysis based on dental models before and after fracture, occlusal force recording in areas of molar, premolar, incisors, and investigation of mandibular movement function during mastication, the results show that: (1) Occlusal relationship is not as satisfied as considered previously when IMF is used to treat mandibular fracture. In some cases, the dental cusps of molar and premolar don't contact tightly in lingual side, the occlusal plane seem to be inclined bucco-lingually. (2) The use of DC plate or EDC plate can avoid long-time IMF and reduce its complications, allow early function of mandibular fracture and follow the principles of biomechanics of combining mobility with static. As long as exact operative procedures, better occlusion than the use of IMF can be achieved.

Adolescent↗
PubMedDate not supplied

[Local hypothermia in the immediate posttraumatic period in mandibular fractures].

In patients with mandibular fractures the early posttraumatic complications were prevented using local hypothermia with ALG-2M device and special applicators which ensured an uniform cooling of tissues adjacent to fractured zone. Moderate local hypothermia of +28 to +32 degrees centigrade caused the pain-relieving and antiswelling effects, as electrophysiological investigations proved.

Alveolar Process↗
PubMed1990

Management of pediatric mandibular fractures.

The incidence of mandibular fractures is rare in the pediatric population when compared to adults. Although the basic principles for management are the same as for the adult, certain anatomical features of the pediatric mandible warrant special attention. Problems such as mixed dentition, unerupted teeth, and ongoing growth in the mandible require careful diagnosis and planning in deciding on the proper treatment.

Child↗
PubMed2006

Diagnosis and management of common maxillofacial injuries in the emergency department. Part 2: mandibular fractures.

The majority of mandibular fractures occur in young males aged 16-30 years. As with all traumas, the history and examination cannot be over emphasised as diagnoses can be made with these tools. It is important when taking an accurate history to ascertain the mode and mechanism of injury (fall, punch, road traffic accident), and the magnitude and direction of the force involved (high or low velocity impact).

Adolescent↗
PubMed1998

[Selection of the method of surgical approach in plate osteosynthesis of mandibular fractures].

BACKGROUND: Plateosteosynthesis by intraoral approach of mandibular fractures gives the best cosmetical result but presents a rather difficult procedure. AIMS: Comparison of intra- versus extraoral approach in plateosteosynthesis of mandibular fractures. METHODS: Plate type, experience of the surgeon, age and sex of the patient, as well as hospital stay and rate of the septic complications were analysed retrospectively in 248 patients of the OMF Department (University Freiburg) with mandibular fractures with respect in view of the operative approach used. RESULTS: The method of osteosynthesis was found to be the strongest determinant. Concerning the surgical approach significant correlation was found between age and sex, and surgical experience. Operative approach was found to have no effect on hospitalization and septic complications. CONCLUSION: Operative approach does not have either medical nor economical consequences in the surgical management of mandibula fractures.

Age Factors↗
PubMed1996

Prevalence of maxillo-mandibular fractures in mainland Tanzania.

In order to evaluate the current trends in maxillo-mandibular fractures, hospital records of all patients who had sustained maxillo-mandibular fractures (in Tanzania Mainland) from 1990-1992 were examined. A specially designed questionnaire was dispatched to Regional Dental Officers to be filled after examining the hospital files of patients. Factors considered were age, sex, date fracture and anatomical site of the fracture. Records of 179 patients who had sustained 187 maxillo-mandibular fractures were identified and analysed. Results showed that the greatest number of maxillo-mandibular fractures occurred in patients between the age group 21-30 years, with a male to female ratio of 3:1. Assault was found to have been the leading aetiological factor (29.9%) followed by motor vehicle and motor cycle accidents (27.3%), falls (18.2%), bar fights (9.1%), sports (8.6%), spouse abuse (3.7%) and work injuries constituted 3.2%. Mandibular fractures out-numbered maxillary fractures in a ratio of 4:1. Of the mandibular fractures, fracture of the body of the mandible occurred most followed by fracture at the angle of the mandible, symphysis, condyle, alveolar and ramus.

Accidents↗
PubMed2001

[New aspects in managing mandibular fractures].

BACKGROUND: The aim of osteosynthetic mandibular fracture treatment is a bony bridging of the fracture gap. The gap distance and the fragment movement determine the micromovement in the gap tissue. They are known to be the main factors associated with the clinical outcome of fracture treatment. LITERATURE: The term fracture stability and the underlying mechanically modulated tissue reactions are not well described in the literature. MODEL: In this article we describe experimental results of strain related bone regenerate reactions in vivo. Additionally, in an in vitro model of osteosynthetic fracture treatment micromovements in the sense of bone strains were determined in the gap area. Implications for the osteosynthetic treatment of mandibular fractures are discussed on the basis of our biological and biomechanical results.

Animals↗
PubMed1993

Treatment of mandibular fractures in the 1980s.

Treatment of 317 mandibular fracture patients between 1981 and 1990 at the Department of Oral and Maxillofacial Surgery, Institute of Dentistry, University of Oulu and Oulu University Hospital were analysed on the basis of patient files and radiographs. The patients had suffered altogether 452 mandibular fractures, most in the condylar region. The treatment was operative in 24% of cases and conservative in 76%. Operative treatment was commoner in edentulous than in partially edentulous or dentate patients. The proportion of operatively treated mandibular fractures increased toward the end of the period. The type of osteosynthesis also changed over the decade as wire and plate osteosynthesis gave way to compression plating and then to titanium miniplate and screw fixation of fractures. The advantages and disadvantages of the treatment methods are discussed and some typical cases using various modern fixation techniques are presented.

Adolescent↗
PubMed1999

Utilization of panoramic radiographs to evaluate short-term complications of mandibular fracture repair.

OBJECTIVES/HYPOTHESIS: Detection of complications after mandibular fracture repair is generally based on the clinical examination. However, postoperative evaluation of the patient often includes imaging of the repaired mandible. At our institution, the majority of patients with mandibular fracture have had at least one panoramic mandible radiograph taken postoperatively. The purpose of this study was to assess whether these radiographic studies contributed to detection of complications and thereby had an impact on the clinical course of the patient. STUDY DESIGN: Retrospective review. METHODS: The available medical records over a 5-and-a-half-year period of all patients who were treated at our institution for a fractured mandible were reviewed. Patients included in the study were those who were followed for at least 2 months and two postoperative visits. RESULTS: Our series of 289 patients included 25 patients with complications. Of these patients, 24 had postoperative panoramic radiographs. All of the complications were discovered based on history and physical examination. In six of the patients with complications, the panoramic radiograph was suspicious for a complication. There were five false-positive studies of the 240 postoperative studies performed in patients without complications. No complications were diagnosed based on radiography. CONCLUSIONS: After surgical treatment of mandibular fractures, panoramic radiographs add little to the physical examination and history toward the detection of complications. We believe that panoramic radiographs need not be used routinely, but may be reserved for patients who have complaints or physical findings suggestive of complications.

Adolescent↗