Functional outcome of galeazzi fracture dislocation treated by open reduction and internal fixation with dynamic compression plate

Background: Galeazzi fracture involves fracture of the distal 1/3rd of radius shaft associated with dislocation of distal radioulnar joint. Open reduction and rigid internal fixation of radius is goal standard treatment. The aim of this study was done to evaluate the functional outcome of Galeazzi fracture dislocation managed by open reduction and internal fixation of radius.Methods: The study was conducted in department of orthopaedics Government Medical college Jammu from December 2018 to February 2021. 30 patients of Galeazzi fracture dislocation were managed with Open reduction and internal fixation of Radius with plating and were followed up to evaluate the results.Results: Age of the patients ranged between 23 years to 60 years with a mean range of 42 years. 22 cases were male (73.3%), 8 cases were females (26.6%). In 19 cases injury was in right side and in 11 cases injury was in left side. In most of the cases injury was due to due to RTA (80%) and in rest of cases injury was due to fall from height (20%).Conclusions: Anatomic restoration of length of the radius with rigid internal fixation is key to satisfactory results in Galeazzi fracture dislocations and K-wire fixation of distal radio ulnar joint is not necessary if anatomic reduction of the joint is obtained by indirect means such as open reduction and internal fixation of the radius and immobilization.

Open Rigid Internal Fixation of Low-Neck Condylar Fractures of the Mandible: Mechanical Comparison of 16 Plate Designs

Background: In the literature, no information on plates for low-neck mandibular condylar osteosynthesis can be found, despite the fact that 30 plate designs have already been published. The aim of this study was to compare any dedicated plates for possible use in low-neck condylar fracture osteosynthesis. Methods: The force required for 1-mm displacement of the fixed fracture fragments and incidents of screw loosening were recorded on polyurethane mandibles among 16 designs of titanium plates fixed by 6-mm screws in a 2.0 system. Results: Double-straight plate fixation was the mechanical gold standard (15.2 ± 3.5 N), followed by A-shape Condylar Plates (14.9 ± 2.1 N), X-shape Condylar Plates (14.2 ± 1.3 N) and Auto Repositioning Plates (11.8 ± 2.4 N). Screw loosening was uncommon, as a minimum of three screws were placed into the condylar part. Fewer screws were lost from the ramus part of the fixation if the plate was attached to the condylar part by three screws. Often, the stability of the ramus screws was lost when there were only two fixing screws in the condyle (p < 0.001). Conclusions: It is advisable to consider the mechanical advantages as one decides which plate to choose for open rigid internal fixation in low-neck condylar fractures, or to only be aware of the significant differences in mobility within the fracture line after fixation with different dedicated plates.

Treatment of Nonunion in the Mandible After Orthognathic Surgery to Correct Transverse Asymmetry of the Face

Purpose: The present study aims to report the reoperation of an unsuccessful orthognathic surgery with the use of heterogeneous graft and hybrid rigid internal fixation. Case Report: We report the case of V.M.S., a 19-year-old female patient with the main complaint of “crooked chin.” The patient revealed that she previously underwent two operations that were conducted by a different team. The first surgery was carried out to correct the dentofacial deformity, while the second one was intended to eliminate a postoperative infection. After a detailed anamnesis, facial analysis, cephalometric analysis with tomography, and examination of gypsum models, we observed mandibular left-handedness and vertical maxillary excess on the right side. In addition to these previously reported problems, there was a nonunion in the region of the sagittal fracture of the left jaw. Results: The patient underwent surgery to correct dentofacial deformity using the Le Fort I maxillary osteotomy technique and bilateral sagittal osteotomy with hybrid rigid internal fixation plus mentoplasty. Conclusion: Six months following the procedure and orthodontic completion, the patient has a satisfactory occlusion and stability of nonunion without the laterognathism in the skeletal and soft tissue profile.

FRATURA DE MANDÍBULA EDÊNTULA ATRÓFICA: RELATO DE CASO

RESUMOA atrofia da mandíbula é mais comumente encontrada em pacientes idosos ou pacientes com perda dentária precoce, tornando tal osso mais suscetível a fraturas devido a diminuição da altura, da espessura óssea e de seu fluxo sanguíneo. O manejo de injúrias em mandíbulas nestas condições deve levar em consideração a idade e a condição sistêmica do paciente, o tempo decorrido desde o trauma e a complexidade do dano. O tratamento visa a redução e imobilização das fraturas a fim de restabelecer forma e função, incluindo técnicas abertas (cirúrgicas) e fechadas (não-cirúrgicas). Em fraturas de mandíbula atróficas, o tratamento não-cirúrgico não costuma ser uma opção viável em virtude da ausência de elementos dentários e pequena área de contato ósseo existente na região da fratura. Sendo assim, a redução aberta com fixação interna rígida tem sido o tratamento padrão associadas a sistemas de perfil pesado como as placas de reconstrução. O presente trabalho tem como objetivo relatar o caso clínico de uma paciente de 87 anos de idade, sexo feminino, leucoderma, atendida no Hospital Federal dos Servidores do Estado, apresentando fratura bilateral em corpo de mandíbula atrófica. Para o tratamento, foi realizada redução e fixação interna rígida com placas e parafusos. A paciente seguiu em controle pós-operatório durante seis meses sem a presença de complicações.Palavras-chave: Fratura mandibular; Mandíbula atrófica; Fixação interna rígida.ABSTRACTJaw atrophy is most commonly found in elderly patients or with early tooth loss, making such bone more susceptible to fractures due to decreased height, bone thickness and blood flow. The management of injuries in jaws in these conditions should take into account the age and the systemic condition of the patient, the time elapsed since the trauma and the complexity of the damage. The treatment aims to reduce and immobilize fractures to restore shape and function, including open and closed techniques. In atrophic mandible fractures, non-surgical treatment is usually not a viable option, due to the absence of dental elements and small area of bone contact in the fractured region. Thus, open reduction with rigid internal fixation has been the standard treatment associated with heavy profile systems. The present study aims to report the clinical case of an 87 years old female patient, leucoderma, attended at Hospital Federal dos Servidores do Estado, presenting bilateral fracture in atrophic jaw body. For treatment, reduction and rigid internal fixation with plates and screws were performed. The patient was followed up for six months without postoperative complications.Key words: Mandibular fracture; Atrophic jaw; Rigid internal fixation

FRATURA DE MANDÍBULA EDÊNTULA ATRÓFICA: RELATO DE CASO

RESUMOA atrofia da mandíbula é mais comumente encontrada em pacientes idosos ou pacientes com perda dentária precoce, tornando tal osso mais suscetível a fraturas devido a diminuição da altura, da espessura óssea e de seu fluxo sanguíneo. O manejo de injúrias em mandíbulas nestas condições deve levar em consideração a idade e a condição sistêmica do paciente, o tempo decorrido desde o trauma e a complexidade do dano. O tratamento visa a redução e imobilização das fraturas a fim de restabelecer forma e função, incluindo técnicas abertas (cirúrgicas) e fechadas (não-cirúrgicas). Em fraturas de mandíbula atróficas, o tratamento não-cirúrgico não costuma ser uma opção viável em virtude da ausência de elementos dentários e pequena área de contato ósseo existente na região da fratura. Sendo assim, a redução aberta com fixação interna rígida tem sido o tratamento padrão associadas a sistemas de perfil pesado como as placas de reconstrução. O presente trabalho tem como objetivo relatar o caso clínico de uma paciente de 87 anos de idade, sexo feminino, leucoderma, atendida no Hospital Federal dos Servidores do Estado, apresentando fratura bilateral em corpo de mandíbula atrófica. Para o tratamento, foi realizada redução e fixação interna rígida com placas e parafusos. A paciente seguiu em controle pós-operatório durante seis meses sem a presença de complicações.Palavras-chave: Fratura mandibular; Mandíbula atrófica; Fixação interna rígida.ABSTRACTJaw atrophy is most commonly found in elderly patients or with early tooth loss, making such bone more susceptible to fractures due to decreased height, bone thickness and blood flow. The management of injuries in jaws in these conditions should take into account the age and the systemic condition of the patient, the time elapsed since the trauma and the complexity of the damage. The treatment aims to reduce and immobilize fractures to restore shape and function, including open and closed techniques. In atrophic mandible fractures, non-surgical treatment is usually not a viable option, due to the absence of dental elements and small area of bone contact in the fractured region. Thus, open reduction with rigid internal fixation has been the standard treatment associated with heavy profile systems. The present study aims to report the clinical case of an 87 years old female patient, leucoderma, attended at Hospital Federal dos Servidores do Estado, presenting bilateral fracture in atrophic jaw body. For treatment, reduction and rigid internal fixation with plates and screws were performed. The patient was followed up for six months without postoperative complications.Key words: Mandibular fracture; Atrophic jaw; Rigid internal fixation.