Case reports from the maxillofacial team, 6th general hospital

Abstract

This 24-year-old soldier suffered a major gunshot wound with complete loss of lower lip and chin and fragmentation of the mandibular symphysis. Multiple penetrating buckshot wounds in the soft parts of the within three weeks of injury, a thorough débridement and firm fixation of the jaws was immediately done. These two measures allowed the suppuration and edema to subside so satisfactorily that he obtained solid union of the lower border, reformed by bone fragments, after ten weeks of extraoral traction by transosseous wires to an extension bar from a plaster head cap. In the meantime, a rope graft from the shoulder had been prepared and swung into position, and approximately three months after admission this was permanently in place. Local flaps were used to reform lower lip and vermilion border. It was found that a rigid metallic splint from premolar to premolar would make further bone grafts unnecessary. He was healed and ready for full combat duty, except for preparation of his permanent acrylic prosthesis, about four and one-half months after entry and about five months after receiving this severe and disfiguring injury.