Colles external fixator as alternative in comminuted mandibular fractures treatment

Abstract

Objective: to report a surgical case of comminuted mandible fracture caused by a firearm projectile treated with external fixation. Methodology: male patient, 18 years old, attended the Emergency Department of the Maxillofacial Surgery service after trauma in the mandibular region by a firearm projectile. On clinical examination, edema was observed in the cervical zone II and mandibular region, penetrating orifice of entry of the projectile in the genial region and mobility in the mandibular body. CT scan revealed a comminuted fracture in the mandible. Transcutaneous perforations were performed with pins, anatomical reduction of the fracture and stabilization to the external nail, adapting to the mandibular anatomy. Following postoperative follow-up, the patient progresses without pain complaints, with functional and satisfactory mouth opening, without mobility in bone fragments, and reestablished mandibular framework. Results and Conclusion: mandibular fractures by firearms are frequent in the routine of the buccomaxillofacial surgeon. Cases of bone comminution present individual peculiarities that must be taken into account in their management. The correct indication of external fixation proved to be adequate and satisfactory for cases of mandible comminution.

Estratégia para redução e fixação de fraturas mandibulares complexas. Um relato de caso

“…Porém, está bem consolidado que o tratamento de fraturas nessas regiões deve ter por objetivo anular as forças de tensão, na borda superior da mandíbula, e compressão, na borda inferior. Sendo a redução aberta e a fixação interna rígida as modalidades eficientes e mais utilizadas com essa finalidade (Oliveira et al, 2021;Paza et al, 2008;Ramalho, Araújo, Santos, Caubi, & Sobreira, 2011;Torres et al, 2020). Segundo Junior et al (2019) variações dentro dessas categorias de tratamento podem existir dependendo do tipo de fratura, da abordagem escolhida para osteossíntese e o método de fixação.…”