Pathologic Fractures of the Mandible

하악골에 발생한 병적 골절

  • Lee, Sang-Woon (Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University) ;
  • Kim, Chan-Woo (Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University) ;
  • Kim, Min-Keun (Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University) ;
  • Kim, Seong-Gon (Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University) ;
  • Kwon, Kwang-Jun (Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University) ;
  • Park, Young-Wook (Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University)
  • 이상운 (강릉원주대학교 치과대학 구강악안면외과학교실) ;
  • 김찬우 (강릉원주대학교 치과대학 구강악안면외과학교실) ;
  • 김민근 (강릉원주대학교 치과대학 구강악안면외과학교실) ;
  • 김성곤 (강릉원주대학교 치과대학 구강악안면외과학교실) ;
  • 권광준 (강릉원주대학교 치과대학 구강악안면외과학교실) ;
  • 박영욱 (강릉원주대학교 치과대학 구강악안면외과학교실)
  • Received : 2011.07.29
  • Accepted : 2011.08.24
  • Published : 2011.11.30

Abstract

Pathologic fractures of the mandible can occur for many reasons including osteoradionecrosis, osteomyelitis, malignancy and cyst. Pathologic fractures are difficult to treat because management is needed not only for the fractures of the mandible but also the underlying disease the is weakening the bone. Additionally, the diseased mandible in the pathologic fracture frequently has abnormal bone healing capacity. We experienced three cases of pathologic fractures of the mandible resulting from cyst, malignancy and osteomyelitis. The treatment of these cases was complicated and time-consuming. Therefore, we present our three cases and discuss the management of pathologic fractures of the mandible.

Keywords

References

  1. Fonseca RJ, Walker RV, Betts NJ, Barber HD, Powers MP, editors. Oral and maxillofacial trauma, I. Philadelphia: Saunders; 2005.
  2. Chuang HC, Wei ST, Lee HC, Chen CC, Lee WY, Cho DY. Preliminary experience of titanium mesh cages for pathological fracture of middle and lower cervical vertebrae. J Clin Neurosci 2008;15:1210-5. https://doi.org/10.1016/j.jocn.2007.11.011
  3. Gruber G, Zacherl M, Leithner A, et al. Surgical treatment of pathologic fractures of the humerus and femur. Orthopade 2009;38:324, 326-8, 330-4.
  4. Gerhards F, Kuffner HD, Wagner W. Pathological fractures of the mandible. A review of the etiology and treatment. Int J Oral Maxillofac Surg 1998;27:186-90. https://doi.org/10.1016/S0901-5027(98)80007-6
  5. Coletti D, Ord RA. Treatment rationale for pathological fractures of the mandible: a series of 44 fractures. Int J Oral Maxillofac Surg 2008;37:215-22. https://doi.org/10.1016/j.ijom.2007.09.176
  6. Wongchuensoontorn C, Liebehenschel N, Wagner K, et al. Pathological fractures in patients caused by bisphosphonaterelated osteonecrosis of the jaws: report of 3 cases. J Oral Maxillofac Surg 2009;67:1311-6. https://doi.org/10.1016/j.joms.2008.12.030
  7. Chrcanovic BR, Custodio AL. Mandibular fractures associated with endosteal implants. Oral Maxillofac Surg 2009;13:231-8. https://doi.org/10.1007/s10006-009-0171-7
  8. Chow AW, Roser SM, Brady FA. Orofacial odontogenic infections. Ann Intern Med 1978;88:392-402. https://doi.org/10.7326/0003-4819-88-3-392
  9. Kim YK, Kim SG. Treatment of mandible fractures using bioabsorbable plates. Plast Reconstr Surg 2002;110:25-31. https://doi.org/10.1097/00006534-200207000-00006
  10. Park HW, Ryu DM, Lee HJ, Huh WS. The effects of resorbable plate in the healing process of mandibular fracture of the rabbits. J Korean Assoc Maxillofac Plast Reconstr Surg 1999;21:131-8.
  11. Urken ML. Composite free flaps in oromandibular reconstruction. Review of the literature. Arch Otolaryngol Head Neck Surg 1991;117:724-32. https://doi.org/10.1001/archotol.1991.01870190036009
  12. Califano L, Zupi A, Maremonti P, Longo F. Pathological fractures of the mandible caused by cancer of the oral cavity. Rev Stomatol Chir Maxillofac 1997;98:312-5.
  13. Plath T, Marks C. Pathologic fracture of the mandible caused by intraosseous metastasis of oesophageal squamous cell carcinoma: a case report. Int J Oral Maxillofac Surg 1996;25:282-4. https://doi.org/10.1016/S0901-5027(06)80057-3
  14. Califano L, Zupi A, Maremonti P, Longo F, Mangone GM, Marinelli A. Pathological fracture of the mandible: a report of a clinical case treated with clodronate. G Chir 1999;20:307-9.
  15. Berenson JR. Treatment of hypercalcemia of malignancy with bisphosphonates. Semin Oncol 2002;29(6 Suppl 21):12-8. https://doi.org/10.1053/sonc.2002.37417
  16. Mhaskar R, Redzepovic J, Wheatley K, et al. Bisphosphonates in multiple myeloma. Cochrane Database Syst Rev 2010;(3):CD003188.
  17. Ogasawara T, Sano K, Hatsusegawa C, Miyauchi K, Nakamura M, Matsuura H. Pathological fracture of the mandible resulting from osteomyelitis successfully treated with only intermaxillary elastic guiding. Int J Oral Maxillofac Surg 2008;37:581-3. https://doi.org/10.1016/j.ijom.2007.11.006
  18. Kuijpers SC, van Roessel EW, van Merkesteyn JP. Unusual case of a conservatively treated pathological fracture after sequestrectomy in a patient with long-term oral bisphosphonate use. J Craniomaxillofac Surg 2011;39:69-72. https://doi.org/10.1016/j.jcms.2010.03.022
  19. van Merkesteyn JP, Balm AJ, Bakker DJ, Borgmeyer-Hoelen AM. Hyperbaric oxygen treatment of osteoradionecrosis of the mandible with repeated pathologic fracture. Report of a case. Oral Surg Oral Med Oral Pathol 1994;77:461-4. https://doi.org/10.1016/0030-4220(94)90224-0