J Korean Assoc Oral Maxillofac Surg.  2012 Feb;38(1):50-54. 10.5125/jkaoms.2012.38.1.50.

Surgical management of edentulous/atrophic mandibular fracture: a report of two cases

• Lim JS
• Kwon JI
• Kim BC
• Kim HJ

• KMID: 1434379
• DOI: http://doi.org/10.5125/jkaoms.2012.38.1.50

Abstract

According to Luhr's classification, a fracture in the mandible with a width of less than 15-20 mm is considered to be an atrophic mandibular fracture and its incidence is very rare. Because of the reduced cross-sectional area and smaller contact area of the fractured ends as well as the poorly vascularized bony structure and delayed bone healing, an atrophic mandibular fracture is a great challenge for oral and maxillofacial surgeons. Surgeons tend to perform closed reduction, because open reduction is considered a non-life-saving surgery among elderly patients. Thus, most of them have limited experience in surgical management. According to recent reports, open reduction yields a good result, and the Association for Osteosynthesis (AO) group has recommended open reduction. This is a case report of our two experiences of open reduction and rigid fixation of atrophic mandibular fractures by the AO principle. Articles were also reviewed here.

Keyword

Atrophy; Edentulous jaw; Mandible; Mandibular fracture; Surgical procedure

MeSH Terms

Aged
Atrophy
Humans
Incidence
Jaw, Edentulous
Mandible
Mandibular Fractures

Figure

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  Fig. 1 Preoperative panoramic view of Case 1. A fracture line was observed on the bilateral body area.

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  Fig. 2 Preoperative 3-dimensional computed tomography view of Case 1. Deviation of bone segment was noted.

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  Fig. 3 Intraoperative photograph of Case 1. A. After a dissection, a bilateral body fracture line was observed, and the mental nerve was preserved. B. Fixation was done, with the mental nerve preserved.

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  Fig. 4 Postoperative panoramic view of Case 1. A. Immediate postoperative panoramic view. Accurate reduction was done. B. Postoperative 3 months' follow-up. There are no hardware fracture and mobility of bony segment.

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  Fig. 5 Preoperative 3-dimensional computed tomography view of Case 2. The fracture line was observed on the right angle and left body.

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  Fig. 6 Postoperative panoramic view of Case 2. A. Immediate postoperative panoramic view. The reconstruction plate was fixed on the mandible inferior border. B. 6 weeks' follow-up. There are no hardware fracture and mobility of the bony segment.

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