Rigid Internal Fixation vs. Traditional Techniques for the Treatment of Mandible Fractures

Hoffman, William Y.; Barton, Ronald M.; Price, Mark S.; Mathes, Stephen J.

doi:10.1097/00005373-199008000-00014

Cited by 38 publications

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“… fast restored occlusal function; optimized reposition; and economic advantages because of less loss at time of work (23–25). …”

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confidence: 99%

“…The proponents of open reduction and internal fixation claim the following advantages: 1. fast restored occlusal function; 2. optimized reposition; and 3. economic advantages because of less loss at time of work (23)(24)(25). The proponents of closed repositioning and intermaxillary splinting claim the following advantages (22): 1. less traumatogenic procedure (22,36,37); 2. preserving the vascularity of the trauma site (22,26); 3. advantages because of shorter hospitalization (8) and…”

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confidence: 99%

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Open or closed repositioning of mandibular fractures: is there a difference in healing outcome? A systematic review

Andreasen

Jensen

Kofod

et al. 2007

Dental Traumatology

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– The clinical outcome of closed vs open reduction and rigid fixation was compared based on a systematic review of the literature. Ten non‐randomized retrospective studies were found. In six of these ten studies, the complication rate was significantly increased when open reduction and plating was performed. In the remaining studies, a slightly elevated (but not significant) infection rate was found when compared with closed reduction. Altogether, an infection rate of 5.0% was found in the closed reduction group whereas 10.6% and 14.6% were found when open reduction was performed using either plates or wires. Nerve injuries were slightly increased when open reduction was found (although not significant). With regard to occlusal disturbances, no difference was found in the open and closed reduction group. Concerning overall complication problems, six of seven studies showed more problems after open than closed reduction. In conclusion, this literature review using retrospective studies has raised doubts regarding the superiority of open reduction and rigid splinting, compared to closed reduction and intermaxillary splinting. However, a bias concerning the preferential use of open reduction in case of more complicated fractures cannot be excluded, which might explain the differences found between the two procedures. Prospective, randomized clinical trials are needed to illuminate this problem.

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“… fast restored occlusal function; optimized reposition; and economic advantages because of less loss at time of work (23–25). …”

mentioning

confidence: 99%

mentioning

confidence: 99%

Open or closed repositioning of mandibular fractures: is there a difference in healing outcome? A systematic review

Andreasen

Jensen

Kofod

et al. 2007

Dental Traumatology

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“…Maxillofacial and mandibular fractures are common injuries 1,3,4 requiring immediate veterinary care and often surgical correction 1,3,5,6,16 . Indications for surgical repair of maxillofacial fractures include dental malocclusion, facial deformity, globe displacement, respiratory compromise, and possibility of bone sequestrum development 1,3,4,6,13 .…”

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confidence: 99%

Surgical correction of severe strabismus and enophthalmos secondary to zygomatic arch fracture in a dog

Konrade

Clode

Michau

et al. 2009

Veterinary Ophthalmology

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A grossly displaced segmental zygomatic arch fracture with marked ventro-lateral deviation of the left globe was diagnosed in a 3-month-old male German Shepherd dog following a bite injury. The fracture was approached via a modified lateral orbitotomy and a fragment of the lacrimal bone removed. The rostral portion of the fracture was stabilized with a 5-hole 2.0 dynamic compression plate bone plate. The surgical correction achieved sufficient skeletal fixation for proper anatomical reduction of the globe and excellent cosmetic and functional outcomes.

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“…In closed reduction, the fracture site is not surgically exposed but the reduction is achieved by palpation of the bony fragments and restoration of the dental occlusion. Open reduction entails exposure of the fracture site to allow direct visualization, validation of the procedure and direct application of a fixation device at the fracture site [2].…”

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confidence: 99%

Radiodensitometric Assessment of the Effect of Pulsed Electromagnetic Field Stimulation Versus Low Intensity Laser Irradiation on Mandibular Fracture Repair: A Preliminary Clinical Trial

Refai

Radwan

Hassanien

2013

J. Maxillofac. Oral Surg.

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Purpose Closed reduction of mandibular fractures usually entails a relatively long period of immobilization, with the subsequent delay of rehabilitation. Therefore, shorter immobilization period with various approaches to protect or enhance bone healing have been investigated. The aim of this study was to analyze the effects of pulsed electromagnetic field (PEMF) and low intensity laser irradiation (LILI) on the fracture healing process, through radiodensitometric assessment of the bone callus. Patients and Methods Eighteen patients with mandibular fractures at the tooth bearing area participated in this prospective study. They were treated by closed reduction using maxillo-mandibular fixation (MMF) and were consecutively assigned into 1 of 3 groups. In group A, the fracture sites were exposed to PEMF for 2 h daily for 12 days. In group B, the fracture sites were exposed to LILI on the tenth and twelfth postoperative days (2 sessions of 6 min per day 2 h apart). The fracture sites in group C acted as controls. MMF was maintained for 2 weeks in group A and 4 weeks in groups B and C. The bone fracture healing was evaluated clinically by investigating the union of the fractured segments and radiographically using computerized densitometry. The union of the fractured segments was tested by manual manipulation and the occlusion was assessed upon removal of MMF. Standardized digital panoramic radiographs were performed for each patient, immediately postoperatively as well as at 2 and 4 weeks. The digital images were manipulated using the IDRISI software. A rectangular area of 10 9 15 mm was drawn along the center of the fracture line. The obtained densitometry values were expressed in gray levels from 0 to 256. The collected data were then tabulated and statistically analyzed. Results After releasing the MMF, the bimanual mobility test of the fractured segments in all patients showed stability of the segments. The preinjury occlusion was maintained in all patients. The postoperative radiographs of all patients revealed good bony alignment of the bony segments. In all groups, comparison between the study intervals with respect to both means and changes percentages of the bone density values showed insignificant differences. At 2nd postoperative week, the mean bone density at the fracture sites decreased by 4.74, 6.6 and 27.89 % in groups A, B and C respectively. The period from the 2nd to the 4th postoperative weeks showed increase in the bone density by 1.49, 1.95 and 14.12 % in groups A, B and C respectively. Insignificant difference was found between the means of bone densities of group A and B throughout the study intervals. On the other hand, both groups showed insignificant difference with group C immediately postoperative and significant increase in bone density at the 2nd and 4th postoperative weeks. Conclusions Short period immobilization of mandibular fractures for 2 weeks supplemented with PEMF is recommended. Further studies are needed to evaluate the efficacy of LILI as a supplement to reduce the m...

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Rigid Internal Fixation vs. Traditional Techniques for the Treatment of Mandible Fractures

Cited by 38 publications

References 0 publications

Open or closed repositioning of mandibular fractures: is there a difference in healing outcome? A systematic review

Open or closed repositioning of mandibular fractures: is there a difference in healing outcome? A systematic review

Surgical correction of severe strabismus and enophthalmos secondary to zygomatic arch fracture in a dog

Radiodensitometric Assessment of the Effect of Pulsed Electromagnetic Field Stimulation Versus Low Intensity Laser Irradiation on Mandibular Fracture Repair: A Preliminary Clinical Trial

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