Maxillofacial Plastic and Reconstructive Surgery

Korean Association of Maxillofacial Plastic and Reconstructive Surgeons (대한악안면성형재건외과학회)
권호 표지

THE SHORT-TERM REMOVABLE INTERMAXILLARY FIXATION CARE BY USE OF AN ADDITIVE INCISION & DRAINAGE ON THE ORAL LACERATION WOUNDS ADJACENT WITH MANDIBULAR COMPOUND FRACTURES: REPORT OF A CASE

하악골 복합 골절시 구내 열창부 상에 추가 절개 배농술을 이용한 단기간 가변적 악간고정 관리: 증례보고

  • Mo, Dong-Yub (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University (Wonju Christian Hospital)) ;
  • Yoo, Jae-Ha (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University (Wonju Christian Hospital)) ;
  • Choi, Byung-Ho (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University (Wonju Christian Hospital)) ;
  • Kim, Ha-Rang (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University (Wonju Christian Hospital)) ;
  • Lee, Chun-Ui (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University (Wonju Christian Hospital)) ;
  • Ryu, Mi-Heon (Department of Oral pathology, School of Dentistry, Yangsan Campus of Pusan National University)
  • 모동엽 (연세대학교 치과대학 구강악안면외과학교실(원주기독병원)) ;
  • 유재하 (연세대학교 치과대학 구강악안면외과학교실(원주기독병원)) ;
  • 최병호 (연세대학교 치과대학 구강악안면외과학교실(원주기독병원)) ;
  • 김하랑 (연세대학교 치과대학 구강악안면외과학교실(원주기독병원)) ;
  • 이천의 (연세대학교 치과대학 구강악안면외과학교실(원주기독병원)) ;
  • 유미현 (부산대학교 치의학 전문대학원 구강병리학교실)
  • Received : 2010.01.18
  • Accepted : 2010.03.29
  • Published : 2010.05.31
Download PDF
⟨ Previous Next ⟩

Abstract

Treatment of the mandibular fracture consists of reduction and fixation. The apparatus that is used to keep the jaws together during healing will often reduce the fracture as well. When the jaws are brought together and intermaxillary elastic rubber traction is placed, the occlusion of the teeth will help to orient the fractured parts into good position. Intermaxillary fixation, that is, fixation obtained by elastic bands between the upper & lower jaws to which suitable anchoring devices have been attached, will successfully treat most fractures of the mandible. Arch bars are perhaps the ideal method for intermaxillary fixation. Several types of ready-made arch bars are used. But, daily occupational life and oral hygiene is difficult to maintain during the period of longterm immobilized intermaxillary fixation (commonly 6-8 weeks), owing to malnutrition and emotional disorders in a position of the patient with mandibular fractures. Most mandibular fractures heal well enough to allow removal of fixation in about 6 weeks. Though there are many complications of mandibular fracture, such as infection, hemorrhage, trismus, paresthesia and nonunion, it is favorable to attain the short-term removable intermaxillary fixation care by use of an additive incision & drainage establishment on the oral lacerated wounds of adjacent mandibular compound fractures. The purpose of an additive incision & drainge establishment is the prevention of wound infection & nonunion by removing the hematoma & seroma in the fracture sites.

Keywords

References

  1. Bradley RL : Treatment of fractured mandible. Am Surg 31 : 289, 1965.
  2. Dingman RO, Izenberg PH : Complications of facial trauma. In : Conley JJ : Complication of head and neck surgery. Philadelphia, WB Saunders, 1979, p.358.
  3. Freihofer HP, Sailer HF : Experiences with intraoral transosseous wiring of mandibular fractures. J Maxillofac Surg 1 : 248, 1973. https://doi.org/10.1016/S0301-0503(73)80048-7
  4. Choung R, Donoff RB, Guralnick WC : A retrospective analysis of 327 mandibular fractures. J Oral Maxillofac Surg 41 : 305, 1983. https://doi.org/10.1016/0278-2391(83)90297-5
  5. Mathog R, Rosenberg Z : Complication in the treatment of facial fractures. Otolaryngol Clin North Am 9 : 533, 1976.
  6. McCoy FJ, Chandler RA, Magnan CG et al : Analysis of facial fractures and their complications. Plast Reconstr Surg 29 : 301, 1962. https://doi.org/10.1097/00006534-196203000-00009
  7. McCallum CA : Complications resulting from maxillofacial injuries. J Oral Surg 27 : 488, 1969.
  8. Prein J, Beyer M : Management of infection and nonunion in mandibular fractures. Oral & Maxillofacial Clinics of North America 2 : 187, 1190.
  9. Mathog R, Boies L : Nonunion of manbible. Laryngology 86 : 908, 1976.
  10. Fonseca RJ, Walker RV : Oral and maxillofacial trauma, Vol II. Philadelphia, WB Saunders, 1991, p.1150.
  11. Roitt IM, Lehner T : Immunology of oral disease, 2nd ed. Edinburg, Blackwell Scientific Publications, 1983, p.279.
  12. Kaban LB, Pogrel MA, Perrott DM : Complications in oral and maxillofacial surgery. Philadelphia, WB Saunders,1997, p.121.
  13. Topazian RG, Goldberg MH : Management of infections of the oral and maxillofacial regions. Philadelphia, WB Saunders, 1981, p.247.
  14. Flynn TR, Hoekstra CW, Lawrence FR : The use of drains in oral and maxillofacial surgery : A review and a new approach. J Oral Maxillofac Surg 41 : 508, 1983. https://doi.org/10.1016/0278-2391(83)90241-0
  15. Zallen RD, Curry JF : Study of antibiotic usage in compound mandibular fractures. J Oral Surg 33 : 431, 1975.
  16. Becker GD : Identification and management of the patient at high risk for wound infections. Head and Neck Surg 8 : 205, 1986. https://doi.org/10.1002/hed.2890080313
  17. Gardner JS : CDC guidelines for prevention of surgical wound infections. Am J Infect Control 14 : 71, 1986. https://doi.org/10.1016/0196-6553(86)90059-3
  18. Mancusi-Ungaro HR, Rappaport NH : Preventing wound infections. Am Family Physician 33 : 147, 1986.
  19. Grossman LI : Endodontic practice, 8th ed. Philadelphia, Lea & Febiger, 1974, p.151.
  20. Lim SS : Clinical endodontics. Seoul, Medical and Dental Publications Co, 1994, p.1.