Secondary Management of Mandible Fractures

Abstract

Mandibular fractures are the most common facial fractures that need surgical intervention. If untreated, these fractures affect a patient's occlusion, degree of mouth opening, and facial symmetry, and could cause infection with significant pain. The goal of any surgical intervention is to restore the preinjury occlusion, even if the preinjury occlusion is abnormal. Initial therapies, whether surgical or conservative, are not always successful, however, and revision or delayed surgical intervention can be challenging. Herein, we review common causes of failure of primary surgical management of mandibular fractures and provide tips to successful secondary intervention.

Keywords

complications - malocclusion - revision - Le Fort osteotomy - secondary repair

• References

• 1 Haug RH, Schwimmer A. Fibrous union of the mandible: a review of 27 patients. J Oral Maxillofac Surg 1994; 52 (08) 832-839
• 2 Mathog RH, Toma V, Clayman L, Wolf S. Nonunion of the mandible: an analysis of contributing factors. J Oral Maxillofac Surg 2000; 58 (07) 746-752 , discussion 752–753
• 3 Stone N, Corneman A, Sandre AR, Farrokhyar F, Thoma A, Cooper MJ. Treatment delay impact on open reduction internal fixation of mandibular fractures: a systematic review. Plast Reconstr Surg Glob Open 2018; 6 (06) e1829
• 4 Kyzas PA. Use of antibiotics in the treatment of mandible fractures: a systematic review. J Oral Maxillofac Surg 2011; 69 (04) 1129-1145
• 5 Habib AM, Wong AD, Schreiner GC. , et al. Postoperative prophylactic antibiotics for facial fractures: a systematic review and meta-analysis. Laryngoscope 2019; 129 (01) 82-95
• 6 Alpert B, Kushner GM, Tiwana PS. Contemporary management of infected mandibular fractures. Craniomaxillofac Trauma Reconstr 2008; 1 (01) 25-29
• 7 Koury M, Ellis III E. Rigid internal fixation for the treatment of infected mandibular fractures. J Oral Maxillofac Surg 1992; 50 (05) 434-443 , discussion 443–444
• 8 Mehra P, Van Heukelom E, Cottrell DA. Rigid internal fixation of infected mandibular fractures. J Oral Maxillofac Surg 2009; 67 (05) 1046-1051
• 9 Benson PD, Marshall MK, Engelstad ME, Kushner GM, Alpert B. The use of immediate bone grafting in reconstruction of clinically infected mandibular fractures: bone grafts in the presence of pus. J Oral Maxillofac Surg 2006; 64 (01) 122-126
• 10 Ostrander BT, Wang HD, Cusano A, Manson PN, Nam AJ, Dorafshar AH. Contemporary management of mandibular fracture nonunion-a retrospective review and treatment algorithm. J Oral Maxillofac Surg 2018; 76 (07) 1479-1493
• 11 Akinbami BO. Reconstruction of continuity defects of the mandible with non-vascularized bone grafts. Systematic literature review. Craniomaxillofac Trauma Reconstr 2016; 9 (03) 195-205
• 12 Pogrel MA, Podlesh S, Anthony JP, Alexander J. A comparison of vascularized and nonvascularized bone grafts for reconstruction of mandibular continuity defects. J Oral Maxillofac Surg 1997; 55 (11) 1200-1206
• 13 Hayden RE, Mullin DP, Patel AK. Reconstruction of the segmental mandibular defect: current state of the art. Curr Opin Otolaryngol Head Neck Surg 2012; 20 (04) 231-236
• 14 Berner T, Essig H, Schumann P. , et al. Closed versus open treatment of mandibular condylar process fractures: a meta-analysis of retrospective and prospective studies. J Craniomaxillofac Surg 2015; 43 (08) 1404-1408
• 15 Cillo Jr JE, Ellis III E. Treatment of patients with double unilateral fractures of the mandible. J Oral Maxillofac Surg 2007; 65 (08) 1461-1469
• 16 Ellis III E, Throckmorton G. Facial symmetry after closed and open treatment of fractures of the mandibular condylar process. J Oral Maxillofac Surg 2000; 58 (07) 719-728 , discussion 729–730
• 17 Ellis III E, Walker RV. Treatment of malocclusion and TMJ dysfunction secondary to condylar fractures. Craniomaxillofac Trauma Reconstr 2009; 2 (01) 1-18
• 18 Laine P, Kontio R, Salo A, Mesimäki K, Lindqvist C, Suuronen R. Secondary correction of malocclusion after treatment of maxillofacial trauma. J Oral Maxillofac Surg 2004; 62 (10) 1312-1320
• 19 Maron G, Kuhmichel A, Schreiber G. Secondary treatment of malocclusion/malunion secondary to condylar fractures. Atlas Oral Maxillofac Surg Clin North Am 2017; 25 (01) 47-54
• 20 Gerbino G, Boffano P, Bosco GF. Symphyseal mandibular fractures associated with bicondylar fractures: a retrospective analysis. J Oral Maxillofac Surg 2009; 67 (08) 1656-1660