External mandibular fixation for gunshot fractures: report of 2 cases

Abstract

High-energy ballistic injuries may cause comminuted facial fractures. Treatment of such fractures might be challenging because of infection and soft-and hard-tissue loss. These cases may not be amenable to open reduction and internal fixation. We present 2 cases of gunshot fractures, for which external fixation was used as a surgical step before definitive treatment. With the use of external fixation, existing infection had been controlled and soft tissues had been restored, which allowed oral rehabilitation with reconstruction plates and autogenous bone grafting, if needed.

Cervical Necrotizing Fasciitis: A Severe Sequela of Open Mandibular Fracture and Delay in Treatment

“…The literature shows external fixation is associated with a complication rate that is as high as 35%, including postoperative infections, cellulitis around the pins, nonunion, malocclusions, and pin loosening. However, it is important to recognize many of these complications are secondary to the use of external fixation almost exclusively in severe comminuted fractures with multiple comorbidities, rather than due to the external fixation procedure itself 10 …”