The Application of the Mini-external Fixation in the Mandibular Fracture

Abstract

From 1998 to 2001, we had applied mini-external fixation in 6 patients as a salvage procedure after failed attempts of mandibular fracture treatment using ORIF and IME, which were complicated with post-operative osteomyelitis. Six patients are all male and the average age was 39 year-old. Only one of these patients had the underlying disease of diabetes mellitus and hypertension. Two cases had concurrent zygomatic fractures, and one patient had sustained traumatic SAH and frontal bone fracture. Postoperative mandibular osteomyelitis was confirmed primarily by pathologic reports, occurring from 13 days or more after surgery. The surgical procedures are as follows: we set up the mini-external fixations as the first step, then we remove the previous lmplants in order to conduct a thorough debridement and eradicate the infectious nidus. The mean follow-up period was 6 months. All patients were free from the infections. And the other achievements were categorized as follows: 1. It provides a good anatomic reduction and stable fixation. 2. It restores an acceptable facial contour even in the face of the serious complications. 3. It helps to maitain a functional occlusion and avoids further neurologic damage. 4. It facilitates post-operative care in oral hygiene and control of the infection. Our mini-xternal fixation has long been used in the field of hand surgery for immobilization of the fractured phalanx or metacapals. Since the mandible is not a heavily weight-bearing flat skeleton, its integrity could be easily maintained by the use of mini-external fixation and the results were encouraging. Herein we like to introduce this materials as an auxillary to treat the complicated mandibular fracture.