Abstract
Background/objectivesGunshot injuries are known to cause severe morbidity and mortality when facial regions are involved. Management of the gunshot wounds of the face comprises of securing an airway, controlling hemorrhage, identifying other injuries and definite repair of the traumatic facial deformities. The objective of the present study was to compare the clinical outcome (infection and nonunion) of open reduction and internal fixation versus closed reduction and maxillo-mandibular fixation (CR-MMF) in the treatment of gunshot injuries of the mandible.Materials & methodsThis study was conducted at Oral and Maxillofacial Surgery Department of Shaheed Zulfiqar Ali Bhutto Medical University/Pakistan Institute of Medical Sciences Islamabad, Pakistan. Ninety gunshot mandibular fractures were randomly allocated in two equal groups. In group-A, 45 patients were treated by open reduction and internal fixation while in group-B, 45 patients were also managed by closed reduction and maxillo-mandibular fixation. Post-operative complications (infection, non-union) were evaluated clinically and radiographically in both groups.ResultsPatients treated by open reduction and internal fixation were having more complications in terms of infection (17.8%) as compared to closed reduction (4.4%) with a p-value 0.044. Whereas non-union was more in closed reduction (15.6%) as compared to open reduction and internal fixation group (2.2%) with a significant p-value 0.026.ConclusionBoth the treatment modalities can be used in the management of gunshot injuries of mandible and there is need for further studies to have clear guideline in this regard in best interest of patients, community and health care providers.
Highlights
Injuries to the maxillofacial region present one of the most challenging problems for healthcare professionals worldwide [1]
In group-A, 45 patients were treated by open reduction and internal fixation while in group-B, 45 patients were managed by closed reduction and maxillo-mandibular fixation
Patients treated by open reduction and internal fixation were having more complications in terms of infection (17.8%) as compared to closed reduction (4.4%) with a p-value 0.044
Summary
Injuries to the maxillofacial region present one of the most challenging problems for healthcare professionals worldwide [1]. Trauma to the facial region is commonly caused by road traffic accidents, assaults, gunshots, falls, sports injury and blast injury [2]. Firearm injury contributes to 10% of all maxillofacial trauma and they have exceptionally increased in the recent years due to terrorism and interpersonal violence [3]. Firearms were the third-leading cause of injury-related deaths in United States of America in 2010, following poisoning and road traffic accidents [4]. Firearm injuries are common in Pakistan as well because of instability in the region, easy availability and supply of all kinds of weapons from the tribal areas.
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