Treatment of Bilateral Edentulous Mandible Fractures Using a Minimally Invasive Technique

Abstract

We performed a prospective study on the treatment of edentulous bilateral mandibular fractures. The purpose of this study was to show that a minimally-invasive approach would be as successful in the treatment of these fractures as a large mandibular reconstruction plate, but with less morbidity and less potential for nerve damage. Seven edentulous patients who had sustained bilateral mandibular fractures underwent open reduction with internal fixation utilizing minimally-invasive techniques. The technique consisted of an extraoral approach utilizing a 2.5-cm incision and placement of a 2.4 rigid fixation plate at the inferior border of the mandible and a 2.0 miniplate at the superior border. In cases where the mandibular height was not sufficient to support two plates, a single 2.4 plate was placed at the inferior border. Clinical Examination- mandibular mobility, sensation, incidence of infection, etc. Radiographic Examination- serial panoramic radiographs In our patient series, utilizing this minimally-invasive, periosteum-sparing technique, all of the mandibular fractures healed uneventfully within a six-week period. One patient underwent removal of one of his plates as he did not like the “feel” of it. All others healed uneventfully. Follow-up ranged from 9 months to 28 months. There were no facial nerve deficits in our patient series. Utilizing this minimally-invasive technique, the treatment of complex edentulous bilateral mandibular fractures can be effectively performed and successfully completed. We believe that this is a result of minimal periosteal stripping, thus keeping the vital blood supply to the fracture segments. Also, by utilizing smaller spanning plates, the natural flexion of the mandible did not alter the adaptation of the plate, as seen with reconstruction plates