Ciencia

Journal of Cranio-Maxillo-Facial Surgery 39 (2011) 600e605

Contents lists available at ScienceDirect

Journal of Cranio-Maxillo-Facial Surgery
journal homepage: www.jcmfs.com

The management of unstable oblique infected mandibular fractures with a 2.3 mm mandibular osteosynthesis reconstruction bone plate
Walid A. Ghanem a, *, Khaled A. Elhayes b, Khalid Saad c
a

Oral & MaxillofacialSurgery Department, Faculty of Dentistry, King Khaled University, Saudi Arabia Oral & Maxillofacial Surgery Department, Faculty of Dentistry, Cairo University, Egypt c Oral & Maxillofacial Surgery Department, Faculty of Dentistry, Tanta University, Egypt
b

a r t i c l e i n f o
Article history: Paper received 28 March 2009 Accepted 9 December 2010 Keywords: Unstable oblique infectedmandibular fractures Mandibular osteosynthesis reconstruction bone plates 2.3 mm

a b s t r a c t
This study is aimed to evaluate the efficacy of 2.3 mm reconstruction bone plates in the treatment of unstable infected mandibular fractures. Material: The study included 32 patients with unstable oblique infected mandibular fractures (23 males and 9 females), with a mean age of 33 years. The patients weredivided into two groups. Group 1 were treated with an osteosynthesis plate (with at least 3 screws on each side of fracture sites) applied to the mandibular fracture site, while in group 2 the bone plate was applied (2 screws on each side of fracture sites) with maxillomandibular fixation (MMF). Clinical and radiographic examinations were carefully assessed preoperatively and postoperatively atfollow-up intervals of 1, 2, 6, 12 months. Postoperative complications in terms of dysocclusion, wound dehiscence and neurosensory disturbances were examined. Result: Postoperative clinical and radiographic results showed that group 1 had quicker bone generation and more precise anatomical alignment of fracture sites than with those in group 2. All patients showed no evidence of infection, platefracture or exposure, malunion, osteomyelitis, neurosensory disturbances, or dental injury. Conclusion: The 2.3 mm reconstruction bone plates provide excellent stability and healing of the unstable infected mandibular fractures provided that the fracture site is fixed by at least 3 screws on each side of the fracture sites. Ó 2010 European Association for Cranio-Maxillo-Facial Surgery.

1.Introduction Mandibular fractures are common facial injuries accounting for 36e59% of all maxillofacial fractures and their treatment is one of the most frequent forms of therapy provided by maxillofacial surgeons (Allan and Daly, 1990; Bochlogyros, 1985). Most of these fractures are solitary, but between 22% and 52% involve 2 or more sites in the mandible (Boole et al., 2001). For the surgeon who operateson patients presenting with facial trauma, fractures of the anterior mandible are common. Although there is a wide variance in the reported percentage of fractures of the anterior mandible, aggregate analysis places this at approximately 17% of all mandibular fractures (Bruce and Fonseca, 1991) while mandibular angle fractures make up 23e42% of all fractures in the mandible (Wittenberg et al.,1997). Traditionally, surgeons have

* Corresponding author. King Khaled Univ., Faculty of Dentistry, Abha, Saudi Arabia. Tel.: þ20 966542621817. E-mail address: walid_dent@yahoo.com (W.A. Ghanem).

attempted to achieve four main goals when repairing the mandibular fractures: anatomical restitution, immobilization, prevention of infection and rehabilitation of function. Meeting these goals isessential for successful bone healing and correct postoperative function of the stomatognathic system (Peled et al., 1989). Techniques for the treatment of mandibular fractures have evolved significantly in the past decade. These techniques have ranged from closed reduction with maxillomandibular fixation (MMF), to open reduction with wire osteosynthesis, to open reduction with either rigid internal...