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A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
Published on: January 28, 2020
Treatment of traumatic mandibular nonunion
J R Bruno1, K G Kempers, K Silverstein
1Department of Oral and Maxillofacial Surgery, Hospital of the University of Pennsylvania, 5 White Building, 3400 Spruce Street, Philadelphia, PA, USA.
The Journal of Cranio-Maxillofacial Trauma
|April 16, 2002
Summary
Successful treatment of mandibular nonunion is achievable with surgical intervention. Combining antimicrobial therapy, debridement, immobilization, and bone grafting effectively manages complex fracture cases.
Area of Science:
- Oral and Maxillofacial Surgery
- Trauma Surgery
- Orthopedic Surgery
Background:
- Mandibular fractures can result in nonunion due to delayed treatment, infection, or inadequate fixation.
- Diagnosis of nonunion involves clinical signs like pain and mobility, alongside radiographic evidence.
Observation:
- Three distinct cases of mandibular nonunion were treated, stemming from gunshot wounds, blunt force trauma, and falls.
- Treatment protocols involved antimicrobial therapy, debridement of the fracture site, segment immobilization, and bone grafting.
Findings:
- Surgical interventions included maxillomandibular fixation, reconstruction plates, autogenous bone grafts (cancellous and iliac crest), and polyglactin mesh.
- All three cases demonstrated successful healing without complications.
Implications:
- Autogenous cancellous bone grafts are recommended over cortical bone due to faster revascularization.
- Custom-molded polyglactin mesh offers effective containment for loose cancellous bone grafts, aiding in union.
