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Decision-making algorithm in treatment of the atrophic mandible fractures.
- Source :
-
Il Giornale di chirurgia [G Chir] 2014 Mar-Apr; Vol. 35 (3-4), pp. 94-100. - Publication Year :
- 2014
-
Abstract
- Aim: Closed treatment of atrophic mandible fractures often results in malunion, pseudoarthrosis and pain. Open reduction and rigid internal fixation (ORIF) is still indicated for displaced atrophic mandible fractures. The Authors report a treatment protocol that allows to gain the best results using reconstruction plates, autologous bone grafting and free fibula flap reconstruction when necessary.<br />Methods: Retrospective analysis of 15 patients with atrophic mandible fractures who underwent treatment between 2007 and 2011. 7 cases did not receive any treatment because of their general condition, while the others 8 were surgically managed by external approach. In all cases load-bearing osteosynthesis plates with locking screws were used; in 2 of them contextual bone grafts were performed; in 1 case mandible reconstruction needed harvesting a free fibula flap.<br />Results: In 6 out of 8 cases complete functional and morphological restoration were obtained without any major complication. In 1 case suppurative infection and necrosis of the bone graft occurred, which made necessary its removing, leaving in situ only the reconstruction plate. In another case, during the first year after surgical treatment, atrophic mandible resorption occurred from one angle to the other, resulting in loss of the anchoring reconstruction plate.<br />Conclusions: ORIF is the gold standard procedure for the of atrophic mandible fractures, because it guarantees best morpho-functional outcomes and predictability. Nevertheless the Authors suggest contextual bone grafting in case of substance loss, or a poor quality bone or for dental implant surgery and free fibula flap in selected cases.
- Subjects :
- Aged
Aged, 80 and over
Algorithms
Bone Plates
Bone Screws
Female
Follow-Up Studies
Fracture Fixation, Internal instrumentation
Humans
Male
Mandibular Fractures pathology
Middle Aged
Plastic Surgery Procedures methods
Retrospective Studies
Treatment Outcome
Bone Transplantation
Fracture Fixation, Internal methods
Internal Fixators
Mandibular Fractures surgery
Subjects
Details
- Language :
- English
- ISSN :
- 0391-9005
- Volume :
- 35
- Issue :
- 3-4
- Database :
- MEDLINE
- Journal :
- Il Giornale di chirurgia
- Publication Type :
- Academic Journal
- Accession number :
- 24841687