• Maxillofacial Plastic and Reconstructive Surgery
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• 제20권2호
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• pp.101-105
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• 1998

Compound comminuted mandibular fracture is defined as the presence of multiple fracture lines with open wound resulting in many small pieces within the same area. The incidence of mandibular comminution is difficult to determine but reported as 2.7~18.6 % incidence among mandibular fractures. There are controversies in the treatment of mandibular comminuted fractures. Treatment of comminuted mandibular fracture has traditionally involved closed reduction in an effort to avoid stripping periostcum from the bony segments, but rigid internal rigid fixation is used more popular at present. The extent of comminution, displacement of bony fragments and patient general conditions are important factors in decision of the treatment methods. When significant bone displacement is present, it is necessary to reduce these comminuted fragments to an anatomic, pretraumatic relationship to restore facial form and function. In these cases, ORIF allows anantomic reduction of comminuted segments as well as pretraumatic occlusion. Gentle handling of the soft tissue, rigid fixation of bony fragments and adequate immobilization are essential for reducing the complications. This is the report the incidence, causes, complications and treatment of the patients who visited our department for compound comminuted mandibular fractures.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제27권1호
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• pp.71-75
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• 2005

This study evaluated retrospectively the treatment method and postoperative complications of communited mandibular fractures. We analyzed the clinical and radiologic data of 14 patients with the comminuted mandibular fractures who were admitted to Chosun University Dental Hospital from January 1998 to December 2003. We reviewed the cause of trauma, fracture sites, treatment methods, and postoperative complications. Thirteen patients (93%) had a successful treatment outcome without complications. Only one patient developed postoperative osteomyelitis requiring early plate removal and sequestrectomy. For the comminuted fractures of mandible, internal fixation using micro- or mini-plate was an effective treatment method with a low incidence of major complications.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제40권3호
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• pp.135-139
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• 2014

This following case report describes the open reduction, internal fixation and the reconstruction of an extensive comminuted mandibular fracture with bilateral condylar fractures in a 19-year-old male patient with an intellectual disability and autistic disorder. He suffered fall trauma, resulting in shattered bony fragments of the alveolus and mandibular body between both mandibular rami, the fracture of both condyles and the avulsion or dislocation of every posterior tooth of the mandible. The patient underwent open reduction and internal fixation between both mandibular rami using a reconstruction plate, open reduction and internal fixation of the shattered fragments using miniplates and screws, and the closed reduction of the bilateral condylar fractures.

• Journal of Dental Anesthesia and Pain Medicine
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• 제18권3호
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• pp.183-187
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• 2018

Complex cervical spine fractures are a serious complications of maxillofacial trauma and associated with high mortality and neurological morbidity. Strict vigilance in preventing further insult to the cervical spine is a crucial step in managing patients who are at risk for neurologic compromise. We report a rare case of a right transverse process of atlas fracture with right-sided vertebral artery injury that was associated with a comminuted fracture of the body and angle of the mandible, which restricted mouth opening. Airway management was performed by an awake fiber-optic nasotracheal intubation, where neck movement was avoided with a cervical collar. Vertebral artery injuries may have disastrous consequences, such as basilar territory infarction and death, and should be suspected in patients with head and neck trauma. After mandibular plating, the patient was on cervical collar immobilization for 12 weeks and anti-coagulant therapy.

• 한국임상수의학회지
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• 제37권6호
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• pp.363-366
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• 2020

A 2-month-old, 50 kg male Korean native calf was referred with bilateral mandibular fractures. The bilateral mandible was hanging loose, with inability to use the jaw, indicated by excessive salivation. Radiography revealed a long oblique fracture in the right mandible, and a short oblique fracture in the left mandible. Computerized Tomography, a different form of radiography, revealed the fracture in the left mandible to be a comminuted fracture. In order to stabilize the bilateral mandible fractures, a combination of bone plate and wiring was applied; in addition, resin was applied to enhance stabilization of the mandible. Six weeks after surgery, the calf was able to masticate and ruminate well. In this case, application of the plate and wiring with resin to bilateral mandibular fractures presented a successful functional recovery. Accordingly, the combination of bone plate and wiring with resin can be an effective technique for treating mandibular fractures.

• 치과방사선
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• 제26권2호
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• pp.65-73
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• 1996

The purpose of this study was to evaluate the clinical and computed tomographic features of 7 cases of maxillofacial gunshot injuries in the suicidal patients visited the emergency room, Capital Armed Forces General Hospital. The obtained results were as follows : 1. The gunshot wounds were directed from submental area to dorsum of nose(3 cases), frontal area(1 case), orbit(1 case), infraorbital area (1 case), and lateral to nasal wing(l case). The shape of inlet in gunshot wounds were round (diameter: l-3cm) and that of outlet were oval shape(size : inlet

• Maxillofacial Plastic and Reconstructive Surgery
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• 제36권6호
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• pp.259-265
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• 2014

Purpose: The purpose of this study is to evaluate the influence of intracapsular fracture lines of the mandibular condyle on the anatomical and functional recovery after non-surgical closed treatment. Methods: Clinical and radiological follow-up of 124 patients with intracapsular fractures of the mandibular condyle was performed after closed treatment between 2005 and 2012. The intracapsular fractures were classified into three categories: type A (medial condylar pole fracture), type B (lateral condylar pole fracture with loss of vertical height) and type M (multiple fragments or comminuted fracture). Results: By radiological finding, fracture types B and M lost up to 24% vertical height of the mandibular condyle compared to the height on the opposite side. In Type M, moderate to severe dysfunction was observed in 33% of the cases. Bilateral fractures were significantly associated with the risk of temporomandibular joint (TMJ) dysfunction in fracture types A and B. Bilateral fracture and TMJ dysfunction were not statistically significantly associated in type M fractures. Conclusion: Most of the mandibular intracapsular condylar fractures recovered acceptably after conservative non-surgical treatment with functional rehabilitation, even with some anatomical shortening of the condylar height. The poor functional recovery encountered in type M fractures, especially in cases with additional fracture sites and bilateral fractures, points up the limitation of closed treatment in such cases.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권2호
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• pp.145-148
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• 2010

Maxillofacial injuries are less common in children than in adolescents and adults. This lower incidence is a result of the relatively small size of mandible, the resilient nature of the bones, and a relatively protected environment, which distinguish the treatment principles of pediatric mandibular fractures from those of the adult. The bone of child is malleable, so pediatric fractures tend to be less displaced and rarely comminuted. Moreover, high regeneration potential of the wound allows more conservative treatment modalities for the pediatric mandibular fracture. High risk of damaging unerupted tooth bud renders many clinicians to resort to more conservative treatment modality for the reduction of displaced segments. This case report describes two successful treatment cases using the circummandibular wiring which was applicated to the fracture on parasymphysis of mandible. Circummandibular wiring can protect the tooth buds, and there is no need for intermaxillary fixation so that it prevents the possible complications of intermaxillary fixation such as the temporomandibular joint ankylosis and the facial growth disturbances. The acrylic splint was removed after 3 weeks, which showed clinically good union across the fracture line without complications. They showed complete clinical and radiological bone healing with an optimum occlusion.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권3호
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• pp.470-487
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• 1996

The purpose of this study was to investigate the dynamic response of the mandible to impact and provide insight into the fracture mechanism of the mandible, by 3-dimensional finite element method. The finite element model of the mandible was developed and calculated using NASTRAN/XL (MSC co. U.S.A.) and the linear dynamic transient analysis was performed according to the impulsive force direction, force type and impulse time to the mandible. At first, the load was applied on the mandibular symphysis, body, angle and subcondylar area in the horizontal mandibular plane and the computed stress-time histories at 14 locations of the mandible were obtained. Secondly, the impulsive force was directed to the symphyseal area with changing the force magnitude and impulse time, and calculated the node displacement at 8 locations of mandible. The conclusions from from this study were as follows. 1. The appearance of impulsive energy transmission was different to the direction of impulse to the mandible. 2. The impulsive stress and deformation were larger in lingual or medial side than buccal or lateral in the mandible. 3. The velocity, appearance of energy transmission and the fracture pattern in mandible were affected rather impulse time than force. 4. The horizontal impact to the one side of mandible did not have effect on the stress and displacement of contralateral mandible. From the above results, fracture pattern in symphysis can be showed as simple or comminuted, multiple or associated in body and angle and solitary in subcondyle area.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제11권1호
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• pp.79-86
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• 1989

The is a retrospective study on the transoral approach to open reduction of the Mandibular fractures. Our study was based on a series of 64 patients with mandibular fractures among 99 patients of facial bone fractures who had been treated by transoral approach with or without extraoral approach at Department of Oral and Maxillofacial Surgery, Yonsei Medical Center, Yonsei University from January 1981 to October 1988. We studied favorite sites of open reduction, fixation methods, results and prognosis related to transoral approaches of Mandibular fractures, and which compared with extraoral approaches. The results obtained are as follows : 1. The transoral open reduction was used more frequently in Mandibular fractures(64.6%) than Midfacial bone fractures(35.4%). Among 64 patients of mandibular fractures, 47 patients(73.4%) were treated only by transoral approach and others(26.6%) were treated by both trans- and extra-oral approach. Among 92 sites of mandibular fractures, 75 sites(81.5%) were treated by transoral approach and 17(18.5%) were treated by extraoral approach. 2. The most favorite site for transoral approach compared with extraoral approach was Symphysis(100%), and Angle(62.5%) was next in order of frequency on Mandibular fractures. 3. Direct Interosseous Wiring(DIW) was most commonly used for fixation(64.6%) and Miniplate osteosynthesis was used next in 28.1%. 4. Simple(39.1%) and Compound(52.2%) fractures were frequently indicated for transoral approach, however comminuted fractures were rarely indicated. 5. The direction of fracture lines on Angle of the mandible did not influence to determine whether transoral approach should be selected or not. However this area seemed to be more difficult to reduce exactly by transoral procedure than other areas because simultaneous superior and inferior fixation was applied predominantly on this area. 6. The success rate of reduction and fixation analyzed from us was more excellent in Direct Interosseous Wiring(29/53=54.7%) than in Rigid Internal Fixation(9/29=31.0%). But it might be depended upon various factors as like as sugeon's skill. 7. The postoperative complication due to transoral open reduction of mandible was not high(12.0%) and this rate was similar with other published reports.