Tratamento tardio de fratura de sínfise mandibular por abordagem extraoral – relato de caso

Abstract

Fractures in the mandibular symphysis region can occur in isolation or in association with condylar fractures, since the force on this region can result in an indirect fracture of the condyles. These, when not adequately addressed, can lead to pseudoarthrosis, increasing the complexity of the treatment. Thus, this article aims to report a clinical case of late treatment of symphysis and mandibular condyle fractures. Male patient, 22 years old, with a history of motorcycle accident. On physical examination, atypical jaw mobility and occlusal dystopia were observed. The image examination confirmed a misaligned fracture in the mandibular symphysis, as well as a low unilateral condyle fracture. That said, the surgical approach to the symphyseal fracture, reduction and fixation, were performed. Anatomical reduction and adequate internal fixation are essential to achieve good fracture healing. For treatment of mandibular fractures, two forms of treatment can be used: closed reduction or open reduction with internal fixation. Different techniques can be used in the symphysis region, such as reconstruction plates, miniplates, and lag screw. The association of the techniques is also indicated, being able to use a compression plate of the system 2.4 in the basilar zone and a mini-plate of the system 2.0 to avoid distraction of the stumps. Mandibular fractures, when not addressed early, can result in inadequate consolidation, making the approach challenging and requiring extraoral approaches with association of fixation techniques that present greater stability.