Evaluation of surgical retreatment of mandibular fractures

Introduction: Mandibular fractures are frequent and their treatment is through rigid fixation. Complications can occur after treatment which may require a new surgical procedure, and there are a few studies about that.

Aim: The purpose of this retrospective study was to evaluate the characteristics and the kinds of treatment did in patients which needed another surgery after treatment of mandibular fractures.

Material and method: From all patients with mandibular fractures treated by rigid internal fixation at a trauma hospital during a 7-year period there were 20 patients (4.7% of cases) who needed a new surgery.

Results: The most common complaints were pain, infection with presence of fistula, and abnormal mobility. In the bacterial culture there was predominance of Staphylococcus aureus. The most frequent radiographic images were diffuse bone resorption, loosening of screws, and visible fracture line. The diagnoses in decreasing order were: nonunion 10 (50%), soft tissue infection associated to screw loosening or plate exposure 7 (35%), osteomyelitis 2 (10%), and malunion 1 (5%). Seven cases of nonunion presented fistula and four of them had bone sequestration. The procedures needed were: new fixation 6 (30%), removal of bone sequestration and new fixation 4 (20%), surgical exploration and removal of fixation material 7 (35%), removal of bone sequestration 2 (10%), and refracture 1 (5%).

Conclusion: Most cases requiring surgical retreatment of mandibular fractures comprised nonunion or soft tissue infection associated to screw loosening, and consequently the main procedures needed were new fixation or surgical exploration with removal of fixation material.

Conflict of interest: None declared.

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Jan 27, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Evaluation of surgical retreatment of mandibular fractures
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