External Fixation for Mandible Fractures

Fractures of the facial skeleton can result in the loss of an aesthetically pleasing appearance and basic function, and many cases subsequently require an operative intervention. The surgeon managing these facial fractures must, at the same time, be cognizant of concomitant injuries, including neurologic, ophthalmologic, and cervical spine issues. For most situations, early stabilization in anatomical position using rigid fixation will give the most accurate reduction for the optimal return of preoperative appearance and function, while reducing long-term soft-tissue contracture.

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“…fragments. 19,20 However, these are relatively rare circumstances, and internal fixation is most often preferred.…”

Section: Clinical Managementmentioning

confidence: 98%

Facial Fractures

Sharabi

Koshy

Thornton

et al. 2011

Plastic and Reconstructive Surgery

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“…When a stronger plate fixation is required, placement is performed along the thicker basal segment ( Fig 3) by using bicortical screws-which engage both the lingual and buccal cortices (Fig 5e)to provide a greater degree of stability without the risk of inferior alveolar nerve or tooth root injury. External fixation pins also must be engaged bicortically along the inferior border to prevent them from loosening (39). In the region of the mental foramen, isolation and protection of the mental nerve are necessary before placing the plates (40).…”

Section: Danger Spacesmentioning

confidence: 99%

“…Although infection is no longer seen as a contraindication for ORIF ( Fig 20), external fixation is still used for the staged repair of grossly infected nonhealing fractures with inadequate soft-tissue coverage (5) (Fig 21). Finally, external fixation may be appropriate for critically injured patients, as pins and fixators can be placed with minimal surgical time (39), and for those with head injuries that preclude early return to function (42). With external fixation, there are generally two bicortical pins placed along the basal bone on each side of the fracture.…”

Section: External Fixationmentioning

confidence: 99%

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Multidetector CT of Mandibular Fractures, Reductions, and Complications: A Clinically Relevant Primer for the Radiologist

Dreizin¹,

Nam²,

Tirada³

et al. 2016

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After the nasal bones, the mandible is the second most common site of facial fractures, and mandibular fractures frequently require open reduction. In the trauma injury setting, multidetector computed tomography (CT) has become the cornerstone imaging modality for determining the most appropriate treatment management, fixation method, and surgical approach. Multidetector CT is also used to assess the adequacy of the reduction and evaluate potential complications in the postoperative period. For successful restoration of the mandible's form and function, as well as management of posttraumatic and postoperative complications, reconstructive surgeons are required to have a detailed understanding of mandibular biomechanics, occlusion, and anatomy. To provide added value in the diagnosis, treatment planning, and follow-up of mandibular fractures, radiologists should be aware of these concepts. Knowledge of the techniques commonly used to achieve occlusal and anatomic reduction and of the rationale behind the range of available treatment options for different injury patterns-from isolated and nondisplaced fractures to multisite and comminuted fractures-also is essential. This article focuses on the use of multidetector CT for pre- and postoperative evaluation of mandibular fractures and outlines fundamental concepts of diagnosis and management-beginning with an explanation of common fracture patterns and their biomechanical underpinnings, and followed by a review of the common postoperative appearances of these fractures after semirigid and rigid fixation procedures. Specific considerations regarding fractures in different regions of the tooth-bearing and non-tooth-bearing mandible and the unique issues pertaining to the edentulous atrophic mandible are reviewed, and key features that distinguish major from minor complications are described. (©)RSNA, 2016.

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“…Internal fixation was thought to result in better fracture immobilization, faster healing, as well as the benefit of avoiding external hardware for several weeks. 1,2 Today, internal rigid fixation is essentially the goldstandard treatment for facial fractures, but there are some specific cases that are more amenable to ex-fix application.…”

mentioning

confidence: 99%

The Role of External Fixation in Trauma and Reconstruction of the Mandible in the Age of Rigid Fixation

et al. 2019

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Internal rigid fixation is the gold-standard treatment for facial fractures, but there are some specific cases that are more amenable to external fixation (ex-fix) application. Herein, we discuss advantages and disadvantages to ex-fix in the modern treatment of comminuted mandible fractures, infected mandible fractures, fractures of the condylar region, oncologic mandibular resection, pediatric mandible fractures, and fractures in the edentulous patient.

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External Fixation for Mandible Fractures

Cited by 29 publications

References 12 publications

Facial Fractures

Facial Fractures

Multidetector CT of Mandibular Fractures, Reductions, and Complications: A Clinically Relevant Primer for the Radiologist

The Role of External Fixation in Trauma and Reconstruction of the Mandible in the Age of Rigid Fixation

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