Comminuted Mandibular Fracture Reduction Like A Jigsaw Puzzle
Facial fractures from road traffic accidents are real nightmares. After sustaining one such accident, a male patient below 30 years of age, reported to Richardsons Dental and Craniofacial Hospital, Nagercoil. He was stable, as he had his initial emergency care elsewhere. It’s been a couple of days since the day of the accident. Unbearable pain, inability to open mouth with back set chin were the complaints mentioned by the patient.
After examining, Dr. Sunil Richardson, Oral and Maxillofacial surgeon, noticed sutures extra orally, made probably to stop bleeding from the laceration on the chin. Intra orally, few wirings for the purpose of dentoalveolar fixation, a puncture in lower lip might be as a result of a hit from the upper front tooth, retruded or descended chin.
Without any further delay, a Cone Beam Computed Tomography imaging (CBCT) was done to visualize the aftermath of the trauma.
CBCT evidenced comminuted fractures in his lower jaw bone or mandible. One segment of the fracture was close to the mental nerve, the lower border segment of the mandible has recessed inwardly because of the muscle pull. On the whole, he had a comminuted symphysis fracture of the mandible.
Open reduction with internal fixation under general anesthesia was planned. His dental occlusion was reasonably good. Fractured segments were reduced carefully, one after the other like solving a jigsaw puzzle. His retruded lower border of the mandible, the part that completes the chin was pulled forward and fixed. Approximately, 6 to 7 segments of the fractured bone were reduced and fixed using titanium plates with screws.
A punctured wound on his lower lip was debrided and sutured securely. Laceration in the chin was re-sutured precisely to reduce scarring. Usually bone heals within a period of 4 to 6 weeks in a healthy young individual.
Dr. Sunil Richardson has accomplished numerous such successful surgeries. We at Richardsons Dental & Craniofacial Hospital, assist to
“Accept the unexpected”.
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