1 May 2014Article
Surgical sequence of reduction in double mandibular fractures treatment
Giovanni Orabona 1Vincenzo Abbate 1Salvatore D’Amato 2Antonio Romano 1Giorgio Iaconetta 3
Affiliations
Article Info
1 Department of Oral and Maxillo-Facial Surgery, School of Medicine, University of Naples, “Federico II”, Naples, Italy
2 Department of Oral and Maxillo-Facial Surgery, School of Medicine, University of Naples “SUN”, Naples, Italy
3 Department of Neurosurgery, School of Medicine, University of Salerno, Salerno, Italy
Ann. Ital. Chir., 2014, 85(3), 207-213;
Published: 1 May 2014
Copyright © 2014 Annali Italiani di Chirurgia
This work is licensed under a Creative Commons Attribution 4.0 International License.
Abstract
AIM: This study aims to clarify, according to our experience, the correct surgical sequence which should be followed in order to treat double mandibular fractures. MATERIAL OF STUDY: From January 2007 to January 2010, we have conducted a retrospective study on a sample of patients operated on in our department. We include only those cases in which the jaw was fractured in 2 places, in particular patients who suffer a fracture in tooth-bearing areas (symphysis, parasymphysis, and anterior body) and also contralaterally in non tooth-bearing areas (posterior body, angle, ramus, and condyle). The sample was divided into 2 groups based on the fracture sequence of reduction. RESULTS: At 1-year follow-up, the group of patients who received first the tooth-bearing fractured areas treatment, followed by treatment of non tooth-bearing fractured area on bifocal mandibular fracture (Group A), showed less postoperative complications and reduced surgical time and costs. DISCUSSION: In patients of group B, the non-execution of rigid IMF for the non tooth-bearing fractures made bone segments more free to move. Thus, reduction and fixation of non tooth-bearing fractures is facilitated, but poses a greater risk of complications. The surgeon in this case does not have the occlusal help guide; thus, the tooth-bearing fracture reduction and the subsequent fixation may be imperfect. CONCLUSION: It is recommended from this study that reduction of the tooth-bearing fragment be prior to that of the tooth-free fragment for the double mandibular fracture.
Keywords
- Double mandibular fractures
- Toothbearing area
- Multiple mandibular fracture
- Non-toothbearing area