Mandibular Fracture Open Reduction and Internal Fixation in the Edentulous Patient using an Intra-oral Approach
Speaker Credentials
MD
Format
Poster
Start Date
6-11-2020 12:00 PM
End Date
6-11-2020 12:15 PM
Abstract
The mandible is the most commonly fractured bone in the face and frequently sustains fractures in multiple locations. Mandibular fractures are classified according to region, including the symphysis, body, angle, and condyle, and occur at anatomic points of weakness. This case report describes an intra-oral approach to mandibular fracture in the edentulous patient. J.B. a 70 year old edentulous Hispanic male presented after an assault with altered mental status and facial injuries. He was intubated for airway protection and found to have extensive panfacial fractures on imaging of the mid face and mandible with fractures extending through the left mental foramen, left condyle and right angle. Workup ruled out associated brain or cervical injury. He had open reduction of the mandible and mid face with oral-maxillofacial surgery via an intra-oral approach given the wide of his mandible and was internally fixated with Stryker miniplates. The fracture extending through the left mental foramen was creatively secured using two miniplates bent so as to not impinge on the nerve. The right angle fracture was fixated using a superior manipulate and a buccal 3-dimensional manipulate. Post operative course was complicated by delirium tremens successfully treated with benzodiazepines. The patient's altered mental status resolved and a thorough cranial nerve exam revealed intact sensation in the distribution of the inferior alveolar nerve. This case highlights the unusual intra-oral approach to open reduction in an edentulous patient given the thickness of his mandible and highlights multiple fixation strategies in the same patient. No grants. No conflicts.
Mandibular Fracture Open Reduction and Internal Fixation in the Edentulous Patient using an Intra-oral Approach
The mandible is the most commonly fractured bone in the face and frequently sustains fractures in multiple locations. Mandibular fractures are classified according to region, including the symphysis, body, angle, and condyle, and occur at anatomic points of weakness. This case report describes an intra-oral approach to mandibular fracture in the edentulous patient. J.B. a 70 year old edentulous Hispanic male presented after an assault with altered mental status and facial injuries. He was intubated for airway protection and found to have extensive panfacial fractures on imaging of the mid face and mandible with fractures extending through the left mental foramen, left condyle and right angle. Workup ruled out associated brain or cervical injury. He had open reduction of the mandible and mid face with oral-maxillofacial surgery via an intra-oral approach given the wide of his mandible and was internally fixated with Stryker miniplates. The fracture extending through the left mental foramen was creatively secured using two miniplates bent so as to not impinge on the nerve. The right angle fracture was fixated using a superior manipulate and a buccal 3-dimensional manipulate. Post operative course was complicated by delirium tremens successfully treated with benzodiazepines. The patient's altered mental status resolved and a thorough cranial nerve exam revealed intact sensation in the distribution of the inferior alveolar nerve. This case highlights the unusual intra-oral approach to open reduction in an edentulous patient given the thickness of his mandible and highlights multiple fixation strategies in the same patient. No grants. No conflicts.