MANAGEMENT PROTOCOL OF MANDIBULAR FRACTURES AT PAKISTAN INSTITUTE OF MEDICAL SCIENCES, ISLAMABAD, PAKISTAN.
AbstractBackground: Maxillofacial trauma is very frequent and associated with a high incidence ofmandibular fractures. Although there is universal agreement as to the treatment goals and basictherapeutic principles of reduction and stabilization, a variety of currently accepted treatmentmodalities indicate a lack of consensus. The authors evaluate the incidence, etiology, managementand complications of 344 mandibular fractures in 228 patients treated in the Department of Plasticand Reconstructive Surgery at Pakistan Institute of Medical Sciences (PIMS), Islamabad,Pakistan, during a three year period. Indications and techniques for closed and open treatment ofmandibular fractures are reviewed along with any complications of these fractures or theirmanagement. Methods: A total of 344 mandibular fractures in 228 patients were included in thisstudy. The sex, age, etiology, presentation, fracture characteristics, associated injuries, variousmethods of management and any pre or postoperative complications were evaluated. Results:Although various devices and techniques have been used to treat these fractures, modern plate andscrew fixation systems have proved to provide the best rigid stabilization, early mobility andassociated with least complications. There was a satisfactory bone healing in all the patients and aminimal complication rate associated with open reduction and internal fixation (ORIF).Conclusion: Mandibular fractures occur with high frequency in road traffic accidents andinterpersonal violence. They are among the most common types of facial fractures treated by theplastic surgeons. They must be managed carefully to maintain the function of the mandible, reestablish proper occlusion, and minimize secondary complications. Open reduction and internalfixation has proven to be the most effective method for treatment of mandibular fractures.Key Words: Maxillofacial; Trauma; Fracture; Mandible; Management
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