J Korean Assoc Oral Maxillofac Surg.  1998 Feb;24(1):140-147.

Conservative care of pathologic fracture by osteoradionecrosis of mandible: report of two cases

• Yoo JH
• Choi BH
• Jung JH
• Jung JH
• Lee WJ
• Won CY
• Kim MK

Abstract

The main pathogenesis of osteoradionecrosis is the initial radiation cellular kill, plus the progressive tissue hypoxia owing to endarteritis, plus late expressions of lethal mutations in stromal cells. Its treatment comprised (1) avoidance of local physical, chemical & biological irritants, (2) wound irrigation, (3) antibiotics & analgesics, (4) superficial sequestrectomy, (5) hyperbaric oxygen therapy, (6) resection and reconstructive surgery, and (7) supportive therapy for systemic condition. Because of the cumulative effect of radiation therapy, it is important to manage the osteoradionecrosis conservatively & continuously, with emotional & physical support. The authors think that conservative care is more essential to the patient of poor systemic condition, than the aggressive resection & reconstructive surgery. We report two cases of pathologic fracture by osteoradionecrosis of mandible that were cared conservatively in the department of dentistry, Wonju Christian Hospital. The contents of treatment are continuous wound dressing, medications (antibiotics and analgesics) in acute infection, incision and drainage on new abscess, emotional support (stress management), proper nutritional and physical supports (exercise and physical therapy). The prognosis of continuous conservative care is relatively favorable.

MeSH Terms

Abscess
Analgesics
Anoxia
Anti-Bacterial Agents
Bandages
Dentistry
Drainage
Endarteritis
Fractures, Spontaneous*
Gangwon-do
Humans
Hyperbaric Oxygenation
Irritants
Mandible*
Osteoradionecrosis*
Prognosis
Stromal Cells
Wounds and Injuries
Analgesics
Anti-Bacterial Agents
Irritants