Fracture of the coronoid and pterygoid processes by firearms: case report

Oliveira, David Moraes de; Vasconcellos, Ricardo José de Holanda; Filho, José Rodrigues Laureano; Cypriano, Rafael Vago

doi:10.1590/s0103-64402007000200016

Cited by 15 publications

(23 citation statements)

References 6 publications

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“…Ao contrário da maioria dos relatos de casos na literatura, os quais trazem grandes destruições teciduais e fraturas, as lesões de baixas intensidades causadas por arma de fogo, podem não trazer riscos a vida do paciente, isso varia de acordo com o calibre da arma, o tipo do projétil e a distância do disparo com o alvo 10,11 . Devido sua posição ser protegida pelo arco zigomático e o complexo zigomático maxilar, as fraturas diretas do processo coronoide são raras, e traumas indiretos como descrito nos dois relatos de casos deste artigo, podem ocasionar sequelas como a pseudoanquilose, quando não tratado imediatamente 12 . O tratamento das fraturas do complexo zigomático ou do processo coronoide variam de acordo com o grau de deslocamento e sintomas clínicos, podendo variar em tratamento conservador, através do controle de dieta ao tratamento cirúrgico, seja redução e fixação da fratura ou a remoção do processo coronoide 7,12,13 .…”

Section: Discussionunclassified

Pseudoanquilose da articulação temporomandibular devido ferimento de arma de fogo: abordagem cirúrgica de dois casos

Bermejo¹,

Zorzi²,

Momesso³

et al. 2018

Arch Health Invest

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A pseudoquililose da articulação temporomandibular (ATM) é uma condição rara muito menos frequente que as anquiloses intracapsulares (verdadeiras). A infecção, o trauma e a artrite são algumas das causas das limitações progressivas para a abertura da boca. O tratamento mais comum consiste em coronoidectomia unilateral ou bilateral. Este artigo tem como objetivo relatar dois casos clínicos de pacientes com pseudoanquilose da ATM devido a uma lesão causada pelo ferimento de arma de fogo, submetidos a coronoidectomia unilateral e remoção de projéteis de arma de fogo sob anestesia geral e acesso intraoral.Descritores: Articulação Temporomandibular: Anquilose; Cirurgia Bucal.

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Section: Discussionunclassified

Pseudoanquilose da articulação temporomandibular devido ferimento de arma de fogo: abordagem cirúrgica de dois casos

Bermejo¹,

Zorzi²,

Momesso³

et al. 2018

Arch Health Invest

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“…1 The coronoid process may also sometimes fracture during the procedures like third molar extractions and sagittal split osteotomy. 2 The frequency of coronoid process fracture is reported to be 1 to 3% of all mandibular fractures and 0.6 to 4.7% of all maxillofacial fractures.…”

Section: Discussionmentioning

confidence: 99%

“…Treatment is controversial and is based on the amount of displacement of the coronoid segment and associated symptoms. 2 Kruger and other authors advocate conservative treatment when there is no displacement and some have advised no treatment. 8 Rapidis…”

Section: Discussionmentioning

confidence: 99%

“…Clinical situations like mandibular third molar extraction and sagittal split osteotomy of mandibular ramus may lead to iatrogenic coronoid process fracture, but are rare. 2 These fractures frequently present with restricted mouth opening and pain, which may be attributed to 4 JB Lingaraj, 5 Arjun Singh [1][2][3][4][5] Department of Oral and Maxillofacial Surgery, VK Institute of Dental Sciences, KLE University, Belgaum, Karnataka, India…”

Section: Introductionmentioning

confidence: 99%

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Mandibular Coronoid Fractures, How Rare?

Kale

Aggarwal

Kotrashetti

et al. 2015

The Journal of Contemporary Dental Practice

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Background: To study the rarity of mandibular coronoid process fractures and treatment strategies based on the displacement of these fractures. Materials and methods:A retrospective study of 11 cases of coronoid process fractures among 307 treated cases from 2008 to 2013 was conducted. Six patients were treated conservatively and 5 underwent ORIF with associated fractures. A statistical analysis of the data obtained after subjective and objective evaluation was done. Results:The incidence of coronoid process fractures was 3.58% of all mandibular fractures analyzed. There was no statistically significant difference found between two treatment modalities, but differences in maximum interincisal opening (MIO) and pain in the postoperative period were significant. Conclusion:We recommend that linear coronoid fractures with minimal displacement can be managed with conservative treatment. For patients with significant displacement of coronoid process, limited mouth opening or concomitant mid-face or lower-face fractures, rigid internal fixation is recommended.

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“…5 In cases of submuscular fractures that might be large enough to interfere with mandibular functions, some authors have recommended an intraoral open reduction and fixation with wire osteosynthesis. 10 In coronoid process fractures, where the mandibular movements are limited due to fibrosis of temporalis muscle, the recommended treatment plan is the removal of the fractured coronoid segment.…”

Section: Introductionmentioning

confidence: 99%

Fracture of the Coronoid Process Associated with Frontosphenoidal Fractures

Baliga

Baptist

2014

Craniomaxillofacial Trauma & Reconstruction

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Fracture of the coronoid process is rare and account for only 0.6 to 4.7% of all facial fractures. 1 They are usually simple and linear fractures with minimal displacement, since the fragment is splinted by the tendinous insertion of the temporalis muscle. But in cases of complex trauma, the bone might be displaced into the temporal fossa. 2 Natvig et al 3 classified coronoid process fractures into two types:1. Intramuscular: where the fracture fragment is within the investing fascial attachment of the temporalis muscle. 2. Submuscular: where the fracture is below the musculotendinous attachment. In these cases, there may be superior and medial displacement of the fragment.The zygomatic complex shields the coronoid process; hence, an isolated coronoid fracture is rarely seen in the absence of an arch fracture. 1 Case Reports Case 1A 40-year-old male patient presented to our trauma center following a road traffic accident. Patient was referred to a neurosurgeon as he had frontosphenoidal trauma. He was managed conservatively by the neurosurgeon for the same.As the patient also had facial injuries and difficulty in opening the mouth, he was referred to us. The computed tomography (CT) scan, apart from the fractures of the cranial bones, revealed a right zygomaticomaxillary complex (ZMC) fracture along with right coronoid, nasal bone, and an incomplete Le fort I fracture (►Fig. 1).All the facial bone fractures, apart from the right coronoid fracture, were managed with open reduction and internal fixation with mini plates. Case 2A 33-year-old male patient presented to our trauma center following a road traffic accident. Patient was referred to a neurosurgeon for the management of head injury. He was managed conservatively by the neurosurgeon.The CT scan revealed frontosphenoidal fractures along with a left ZMC and left coronoid fracture (►Fig. 2).Patient was managed with open reduction and internal fixation for the ZMC fracture and the coronoid process fracture was managed conservatively.As both our patients had intramuscular coronoid fractures, they were managed conservatively for the same. They recovered uneventfully, and were asymptomatic postoperatively with no difficulty in mouth opening and lateral excursions of the mandible. DiscussionFractures of the coronoid process are often not evident clinically. Many such injuries go undiagnosed 4 because it is difficult to radiologically diagnose these fractures with Keywords ► coronoid process fractures ► frontosphenoidal injury ► treatment options AbstractCoronoid process fractures are rarely encountered, commonly undiagnosed, usually asymptomatic, and most commonly treated conservatively, hence very little written about. We present two cases of coronoid process fractures with associated frontosphenoidal injuries.

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Fracture of the coronoid and pterygoid processes by firearms: case report

Cited by 15 publications

References 6 publications

Pseudoanquilose da articulação temporomandibular devido ferimento de arma de fogo: abordagem cirúrgica de dois casos

Pseudoanquilose da articulação temporomandibular devido ferimento de arma de fogo: abordagem cirúrgica de dois casos

Mandibular Coronoid Fractures, How Rare?

Fracture of the Coronoid Process Associated with Frontosphenoidal Fractures

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