Treatment of Edentulous Mandibular Fractures with Rigid Internal Fixation: Case Series and Literature Review

The aim of the study is to analyze the effectiveness of rigid internal fixation (RIF) for treating edentulous mandibular fractures. Because of the low incidence of fractures in edentulous mandible, there is no consensus of the optimal treatment for it. This study included all edentulous patients with mandibular fracture diagnosis, who were treated with internal fixation at the Hospital Italiano de Buenos Aires from November 1991 to July 2011. Data such as age, gender, etiology and location of fracture, surgical approach, type of osteosynthesis used, and postoperative complications were analyzed. A total of 18 patients, 76.2 years mean age, 12 females (66.6%), presented a total of 35 mandibular fractures. The mandibular body was the most common localization of the fractures. Twenty-five fractures received surgical treatment with RIF, mainly approached extraorally. Reconstruction plates were the most common type of fixation used. Fracture reduction was considered satisfactory in 96.5%, with 22.2% of complications and 11.1% of reoperations needed. Open reduction and RIF demonstrated to be a reliable method for treating edentulous mandibular fractures. Nevertheless, there is lack of high-level recommendation publication to support this.

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Failed Fixation in Atrophic Mandibular Fractures: The Case against Miniplates

Craniomaxillofacial Trauma & Reconstruction ◽

10.1055/s-0031-1286114 ◽

2011 ◽

Vol 4 (3) ◽

pp. 145-150 ◽

Cited By ~ 11

Author(s):

Matthew J. Madsen ◽

George M. Kushner ◽

Brian Alpert

Keyword(s):

Internal Fixation ◽

Patient Management ◽

Mandibular Fractures ◽

Medical Problems ◽

Difficult Patient ◽

Load Bearing ◽

Rigid Internal Fixation ◽

Improved Outcomes ◽

Edentulous Mandible

Despite advances in the treatment of the fractured atrophic edentulous mandible, treatment continues to be difficult. Patient management is more complicated due to patients often being elderly with more complex medical problems. Rigid internal fixation has greatly improved outcomes with shorter treatment times, yet a consensus has yet to be reached regarding which method yields the most predictable results. Options include using small miniplates to larger reconstruction plates. Although each method has advantages, we present our experience with retreatment of failed miniplate fixation using load-bearing reconstruction plates of fractured atrophic edentulous mandibles.

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Rigid Internal Fixation of Mandibular Fractures—Basics of AO Technique

Otolaryngologic Clinics of North America ◽

10.1016/s0030-6665(20)31614-5 ◽

1987 ◽

Vol 20 (3) ◽

pp. 441-456 ◽

Cited By ~ 5

Author(s):

Joachim Prein ◽

Robert M. Kellman

Keyword(s):

Internal Fixation ◽

Mandibular Fractures ◽

Rigid Internal Fixation

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Rigid internal fixation with titanium versus bioresorbable miniplates in the repair of mandibular fractures in rabbits

International Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.ijom.2004.03.016 ◽

2005 ◽

Vol 34 (2) ◽

pp. 167-173 ◽

Cited By ~ 23

Author(s):

E. Hochuli-Vieira ◽

M.A. Cabrini Gabrielli ◽

V.A. Pereira-Filho ◽

M.F.R. Gabrielli ◽

J.G. Padilha

Keyword(s):

Internal Fixation ◽

Mandibular Fractures ◽

Rigid Internal Fixation

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Concepts and Challenges in the Surgical Management of Edentulous Mandible Fractures: A Case Series

Craniomaxillofacial Trauma & Reconstruction Open ◽

10.1055/s-0039-1693038 ◽

2019 ◽

Vol 3 (1) ◽

pp. s-0039-1693038

Author(s):

Venkatesh Anehosur ◽

Twinkle Thakker ◽

Nikhil Nagraj ◽

Niranjan Kumar

Keyword(s):

Mineral Content ◽

Bone Fractures ◽

Case Series ◽

Mandibular Fractures ◽

Rigid Fixation ◽

Functional Rehabilitation ◽

Edentulous Mandible ◽

High Incidence ◽

Choice Of Treatment ◽

Mandible Fractures

Functional rehabilitation of complex edentulous or atrophic mandibular fractures is surgically demanding. The high incidence of bone fractures in geriatric age group is secondary to the loss of bone mineral content with age. So far, there is no consensus regarding the best treatment for repair of fractures of the severely atrophic mandible. Thus, the choice of treatment for such fractures should be based on the degree of atrophy, considering its inverse relationship to the amount of rigid fixation required. Hence, open reduction and internal fixation (ORIF) is considered to be a reliable method for treating the edentulous mandible fractures. The authors present a case series of patients treated with ORIF with load bearing (LB; reconstruction plate) and load sharing (LS; miniplates) principles. No complications related to infection, plate exposure, fibrous union, nonunion, and trismus, were observed.

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