Mandibular Ramus Fracture: An Overview of Rare Anatomical Subsite.

Anendd Jadhav,Atul Kala,Rahul Deshmukh,Bhushan Mundada,Apoorva Mishra,Kapil Waghwani,Umesh Bhutekar

doi:10.1155/2015/954314

Abstract

Aim. The present study aims at exemplifying the incidence, and aetiology and analyses the outcomes of open reduction internal fixation (ORIF) over closed treatment of mandibular ramus fractures. Patients and Method. In the present retrospective analysis of mandibular fracture patients, variables analysed were age, sex, cause of injury, pretreatment occlusion, treatment given, period of maxillo-mandibular fixation (MMF), and posttreatment occlusion. Results. Out of 388 mandibular fractures treated, ramus fractures were 12 (3.09%). In the present study, predominant cause of mandibular ramus fracture was road traffic accident (RTA) n = 07 (58.33%) followed by fall n = 04 (33.33%) and assault n = 1 (8.33%). The average age was 35.9 years with a male predilection. Of these, 9 patients were treated with ORIF while remaining 3 with closed treatment. The average MMF after closed treatment was 21 days and 3 to 5 days after ORIF. There was improvement in occlusion in all 12 patients posttreatment with no major complication except for reduced mouth opening in cases treated with ORIF which recovered with physiotherapy and muscle relaxants. Conclusion. Mandibular ramus fractures accounted for 3.09% with RTA as a common aetiology. ORIF of ramus fractures facilitated adequate functional and anatomic reduction with early return of function.

Highlights

Since the earliest report on mandibular fractures dating back to 1650 BC in Egypt [1], oral and maxillofacial surgeons have studied the pattern of mandibular fractures without reaching a consensus on the most common pattern
The present study aims at exemplifying the incidence and aetiology and analyses the outcomes of open reduction and internal fixation (ORIF) over closed treatment of these fractures
A retrospective analysis was conducted of the medical records of all trauma patients who presented with signs and symptoms associated with mandibular fractures on presentation to Department of Oral and Maxillofacial Surgery, Acharya Vinoba Bhave Rural Hospital, Datta Meghe Institute of Medical Sciences, from May 2010 through May 2015

Summary

Introduction

Since the earliest report on mandibular fractures dating back to 1650 BC in Egypt [1], oral and maxillofacial surgeons have studied the pattern of mandibular fractures without reaching a consensus on the most common pattern. Despite the fact that the mandible is the largest and strongest facial bone, it is very frequently fractured (second to nasal bone fractures) as a result of the prominent and exposed position of the head It is generally occurring 2 to 3 times as often as midfacial fractures [3]. Ramus is draped by masseter buccally, medial pterygoid muscle lingually, and pterygomasseteric sling at lower border, which facilitates minimum displacement of ramus after it gets fractured Because of this obvious reason, most of surgeons manage this fracture by closed treatment. The present study aims at exemplifying the incidence and aetiology and analyses the outcomes of open reduction and internal fixation (ORIF) over closed treatment of these fractures

Patients and Method

Observation and Results

Discussion

Conclusions