Refracture reposition of mandibular malunion

The second most frequently injured facial bone is the mandible. For this reason, the incidence of mandibular fractures remains high and will continue to represent a considerable percentage of acute major facial injuries encountered by reconstructive surgeons. Fortunately, to this date, complications have been relatively rare. We present our series evaluating the late sequelae from 135 patients treated by the Division of Plastic Surgery at the University of California, Davis Medical Center, Sacramento, California, for mandible fractures during the period July 1, 1987, to June 30, 1988. From this retrospective record review, we found only six patients who required correction of established traumatic deformities. We report the surgical procedure used in these six patients and an additional two patients referred to our center for surgery. From these eight patients, we delineate the anatomical and functional deformities of mandibular malunion as well as the etiological factors. We will present our surgical method using articulating dental models and occlusal splints, and the application of rigid internal fixation with miniplates and screws for stabilization. All patients in the study presented with either malocclusion or facial asymmetry. We were able to return to each of the patients satisfactory mandibular function and facial symmetry.