Thoracic spine teardrop fracture – A case report

This is a case report of a young man who suffered from an anterior inferior angle fracture (teardrop) of the thoracic spine at the dorsal spine third vertebra (D3). It was due to a road traffic accident and led to paraplegia and hypoesthesia below D7 dermatome. The patient was treated with decompression and posterior stabilization using pedicle screw fixation followed by physiotherapy. Teardrop fracture is a type of cervical fracture that is associated with high morbidity and mortality due to its instability, with no reported similar fracture pattern at the thoracic spine level. This is a unique case of a thoracic teardrop fracture that was treated surgically with a posterior approach, a good clinical outcome, and 18 months follow-up.

125 The Fate of The Third Molar in The Line of a Mandibular Angle Fracture: A Retrospective Study at A Tertiary Centre

Aim: To evaluate the risk of complications associated with retaining or extracting an asymptomatic third molar in the line of an angle fracture. Aiming to seek a consensus whether third molars should be extracted or retained during surgical repair of mandibular angle fractures. Method A retrospective study was undertaken at the Queen Elizabeth Hospital, Birmingham. 150 patients across a span of three years underwent open reduction and internal fixation of mandibular angle fractures with third molar involvement. Patients were classified into two groups, tooth retention during angle fracture and tooth removal during angle fracture repair. Hospital records were evaluated to seek the rate of post-operative complications at follow-up Results 162 angle fractures were identified with ipsilateral wisdom teeth present. In 37 cases the wisdom tooth was removed during surgery. 6 complications (16.2%) occurred in this group necessitating a return to theatre. In 125 cases the wisdom tooth was left in-situ. Complications necessitating a return to theatre occurred in 14 cases (11.1%). Conclusions This study indicates that retention of wisdom tooth overall did not significantly increase the risk of complications associated with angle fractures (p = 0.42). Where wisdom tooth pathology was noted its retention was associated with complications requiring a return to theatre (X2=4.40, p = 0.036).

The influence of wisdom tooth impaction and occlusal support on mandibular angle and condyle fractures

This study aimed to analyze the relationship of the occlusal support together with the lower third molars to the mandibular fractures of the angle and condyle among patients in our medical institutions. This was a retrospective study that reviewed the medical records and radiographs of all patients treated for mandibular fractures from 2015 to 2019. The data collected by using picture archiving and communicating system. Only records with mandibular angle or condyle fractures were included. The dependent variable was the presence of the fractures of the mandibular angle or condyle. The independent variables were epidemiological data, third molar characteristics, existence or absence of occlusal support. The data was analyzed through Univariate logistic regression and multivariate logistic regression. From a total of 187 mandibular fractures, 44 presented mandibular angle fracture and 29 shown condyle fractures. The average age was 40.34 ± 13.47 years. The absence of occlusal support increased the chance of condyle fractures by 5.1 times (95% CI 1.61–17.29). The lack of occlusal support is more associated with condyle fractures than the presence of occlusal support, regardless of third molar presence and characteristics and other variables evaluated.