Cranial Maxillofac Trauma Reconstruction 2018; 11(02): 150-156
DOI: 10.1055/s-0037-1601865
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA

Virtual Surgical Planning for the Management of Severe Atrophic Mandible Fractures

Jaime Castro-Núñez
Division of Oral and Maxillofacial Surgery, University of Kentucky, Lexington, Kentucky
Institución Universitaria Colegios de Colombia. Bogotá, Colombia
,
Jared M. Shelton
Division of Oral and Maxillofacial Surgery, University of Kentucky, Lexington, Kentucky
,
Susan Snyder
Division of Oral and Maxillofacial Surgery, University of Kentucky, Lexington, Kentucky
,
Joseph Van Sickels
Division of Oral and Maxillofacial Surgery, University of Kentucky, Lexington, Kentucky
› Author Affiliations
Further Information

Publication History

22 December 2016

05 February 2017

Publication Date:
19 April 2017 (eFirst)

Abstract

Severely atrophic mandible fractures are frequently a challenge to treat. Virtual surgical planning (VSP) uses three-dimensional computed tomographic (CT) scans that can be translated into stereolithographic models to fabricate surgical templates, facilitating intraoperative procedures. The purpose of this article is to describe the reconstruction of two cases of severe atrophic mandible fracture using VSP. Two elderly edentulous/partially dentate patients who presented with fractures of their mandibles and who underwent reconstruction using VSP were included. Both had Class III atrophy at the region of the fracture. While both fractures were complex, the mechanism of injury differed with one being a tractor accident and the other being a pathologic fracture. Both patients presented with critical medical conditions. CT scans were obtained on both. The displaced segments were aligned virtually using mirror images and the midline of the maxilla. Three-dimensional models were fabricated to allow preoperative contouring of 2.5-mm reconstruction plates. Patients were operated under general anesthesia and fractures reduced and stabilized with 2.5-mm reconstruction plates placed at the lateral border of the mandible. Average treatment time for both patients was a little over 2 hours. There was good reduction with both. VSP is a valuable tool to assess and reduce complex fractures with less surgical time and predictable results.