Injury to Anatomic Structures Due to Fixation Device in Management of Mandibular Fracture

Area of Science:

• Oral and Maxillofacial Surgery
• Trauma Surgery
• Anatomy

Background:

• Open reduction and internal fixation (ORIF) is standard for mandibular fractures.
• Potential complications include infection, nerve damage, and tooth root injury from fixation hardware.
• Hardware placement near vital structures can lead to postoperative issues.

Purpose of the Study:

• To evaluate potential injury to anatomical structures near the fracture line caused by fixation devices.
• To assess the proximity of fixation hardware to the inferior alveolar nerve canal and tooth roots.

Main Methods:

• Retrospective study of maxillofacial trauma patients treated with ORIF for mandibular fractures.
• Follow-up at 1 week, 1 month, 3 months, and 6 months.
• Cone-beam computed tomography (CBCT) used to investigate postoperative complications.

Main Results:

• 67 patients (86 fracture lines) were analyzed.
• 7 patients experienced temporary unilateral paresthesia of the lower lip and chin.
• CBCT showed a mean screw distance of 3.02 mm from the inferior alveolar nerve canal; no nerve or tooth root injuries were detected.

Conclusions:

• While complications like paresthesia can occur, careful selection and placement of fixation devices, especially screw length, are crucial.
• No hardware encroachment on the inferior alveolar nerve or tooth roots was observed in this study.
• Appropriate fixation device selection minimizes risks to adjacent anatomical structures.