Mandibular Fracture Patterns in a Rural Setup: A 7-Year Retrospective Study

Uppada, Uday Kiran; Sinha, Ramen; Susmitha, M; Praseedha, B.; Kiran, Ballamudi Sarat Ravi

doi:10.1007/s12663-020-01358-3

Cited by 6 publications

(4 citation statements)

References 16 publications

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“…Previous studies have revealed that incidence of hardware removal was higher in patients undergoing ORIF for maxillofacial trauma than any other procedure. [ 6 13 ] It could be attributed to the greater duration of the exposed fracture site to the oral environment, poor oral hygiene maintenance, or patient’s age. [ 14 ] Following orthognathic surgery, it was noted that the majority of the patients choose to get the hardware removed on their own accord and not due to complications.…”

Section: Discussionmentioning

confidence: 99%

“…A few studies reported that the majority of the patients underwent hardware removal during the first year, while a few studies reported that most patients required hardware removal within 6 months following surgery. [ 13 16 17 ] It is advocated that the hardware removal is easier within 6 months following surgery and with an increase in time, it would become difficult to remove the hardware, particularly in young patients in whom the hardware is often covered by bone. [ 16 ] A previous study revealed that a residual granulation tissue forms around long-standing hardware which becomes necrotic, leading to long-standing inflammation and necrosis.…”

Section: Discussionmentioning

confidence: 99%

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Compositional and surface changes of retrieved stainless-steel hardware and its effects on surrounding soft tissues: A prospective study

James,

Uppada,

Bharadwaj

et al. 2024

National Journal of Maxillofacial Surgery

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Purpose: To evaluate the surface, compositional, and histological changes in the overlying soft tissues of retrieved stainless-steel mini-plates and screws used for rigid internal fixation in the maxillofacial skeleton. Materials and Method: A prospective study was conducted comprising 60 patients who sustained maxillofacial trauma and underwent ORIF in our unit previously and who required hardware retrieval in the post-operative phase. The retrieved hardware was evaluated for surface and compositional changes with the help of a scanning electron microscope for surface roughness and corrosion changes. Energy-dispersive X-ray study was done to know the composition and metal release from the hardware. The data obtained from these results were compared with a control unused and a sterile stainless-steel mini-plate and screw. The effects of the corrosion changes of this hardware on the adjacent soft tissues were evaluated histologically to assess the cellular changes of the soft tissue cover overlying the stainless-steel mini-plates and screws. Results: A total of 96 stainless-steel mini-plates and 380 stainless-steel screws were retrieved from 60 patients. The control plate was smooth without any surface and corrosion defects, while the retrieved mini-plates irrespective of the reason for removal have shown surface roughness. Fe and Ni ions were found to be significantly reduced in the retrieved mini-plates. The presence of CrC in the retrieved plates indicates corrosion, which was seen only in hardware retrieved from symptomatic patients. The histological study revealed chronic inflammatory cell infiltrate with hyalinized connective tissue in all the samples irrespective of the reason for the removal of the plate. Conclusion: Stainless-steel mini-plates and screws act as a potent foreign body material and initiate a localized inflammatory reaction due to its corrosive products with longer duration of stay. Hence, the authors advocate the overall shift in the use of stainless-steel hardware to titanium hardware for ORIF.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Compositional and surface changes of retrieved stainless-steel hardware and its effects on surrounding soft tissues: A prospective study

James,

Uppada,

Bharadwaj

et al. 2024

National Journal of Maxillofacial Surgery

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“…The mandibular condylar process is among the most frequent fracture sites, accounting for about 19-52% of mandibular fractures [1][2][3][4][5]. The crucial aspects in the treatment of condylar fractures include the restoration of mandibular ramus height, occlusion, facial asymmetry, and jaw function [6].…”

Section: Introductionmentioning

confidence: 99%

Postoperative Complications following Open Reduction and Rigid Internal Fixation of Mandibular Condylar Fracture Using the High Perimandibular Approach

et al. 2023

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The high perimandibular approach is a feasible surgical technique for treating mandibular condylar fractures with open reduction and internal fixation, followed by fewer complications. Temporary trismus is the only postoperative complication that may occur. This study evaluated postoperative complications following open reduction and rigid internal fixation (OR-IF) of mandibular condylar fractures using the high perimandibular approach. Twenty consecutive patients undergoing OR-IF were included in this study. They included 11 male and 9 female patients, of an average age of 58.5 years, all of whom responded to a follow-up call at least 12 months after the surgery. All patients were evaluated for range of mouth opening, postoperative complications, and radiological findings. A statistical analysis of the relationship between range of mouth opening and related clinical parameters at 6 months postoperative evaluation was conducted. The fracture of the condylar neck was associated with a limited range of mouth opening and longer operation time. However, longer operation time was not associated with a limited range of mouth opening. The high perimandibular approach with OR-IF in mandibular condylar fractures is a feasible and safe technique; however, prolonged surgery and mandibular condylar neck fractures could affect the postoperative range of mouth opening.

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“…Mandibular fractures are extremely frequent in facial trauma, and 19%–52% involves the condyle. [ 1 2 3 ] As a consequence of condylar fracture, patient may encounter pain, restricted mandibular movement, muscle spasm and deviation of the mandible, malocclusion, and pathological changes in the temporomandibular joint (TMJ), osteonecrosis, facial asymmetry, and ankylosis. [ 4 5 ] The majority of mandibular condyle fractures involve the condylar neck, with few reports of intracapsular fractures.…”

Section: Introductionmentioning

confidence: 99%

Is Open Reduction and Internal Fixation Sacrosanct in the Management of Subcondylar Fractures

Dayalan

Kumari

Khanna

et al. 2021

Journal of Pharmacy and Bioallied Sciences

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Purpose: This paper is intended to compare and evaluate the better treatment option in the management of subcondylar fractures of the mandible. Materials and Methods: This study included 20 patients who were diagnosed clinically and radiologically to have sustained an isolated subcondylar fracture of the mandible. They were divided into two groups randomly. Group I included 10 patients who underwent treatment by intermaxillary fixation alone followed by active physiotherapy in the form of conservative management. Group II included 10 patients who underwent treatment by surgical intervention for open reduction and internal fixation under general anesthesia following elastic guidance. Factors such as maximal mouth opening, pain scores, and deviation of mandible on mouth opening were taken into consideration and evaluated. Results: It is observed that the patients in Group I had weight loss and restrictions in their social well-being in the early recovery phase, in addition to delay in return to function. In spite of the early return to function, patients in Group II were subjected to all kinds of surgical complications such as transient facial nerve injury, infection, and unesthetic scar. The maximal mouth opening and deviation of the mandible on mouth opening remained almost the same in both groups. Conclusion: A regular follow up of operated patients post trauma is essential to obtain morphological and functional recovery. When the respective advantages and disadvantages of both treatment options were compared and evaluated, it was observed that patients treated by closed reduction had a better clinical and psychological outcome.

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Mandibular Fracture Patterns in a Rural Setup: A 7-Year Retrospective Study

Cited by 6 publications

References 16 publications

Compositional and surface changes of retrieved stainless-steel hardware and its effects on surrounding soft tissues: A prospective study

Compositional and surface changes of retrieved stainless-steel hardware and its effects on surrounding soft tissues: A prospective study

Postoperative Complications following Open Reduction and Rigid Internal Fixation of Mandibular Condylar Fracture Using the High Perimandibular Approach

Is Open Reduction and Internal Fixation Sacrosanct in the Management of Subcondylar Fractures

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