Use of Extraoral Multidirectional Distractor as an External Pin Fixator: A Novel Technique in the Management of Comminuted Mandibular Fracture

Abstract

Backgroud: The treatment of comminuted fractures of the mandible is one of the most complex situations that the oral and maxillofacial surgeon is facing within his practice. The aim of the current study was to evaluate the use of extraoral multidirectional distractor as an external pin fixator in comminuted mandibular fracture. Methods: Five male patients (age range from 23 to 37 years) with comminuted mandibular fractures were included in this study. Under general anesthesia, the extraoral multidirectional distractor was applied and used to reduce the fracture segments without intermaxillary fixation followed by checking the occlusion for any disturbance that can be corrected by the distractor. After evaluation of the reduction of the fracture segments by panoramic and lateral mandibular X-ray views, self-cure acrylic resin was used to stabilize the pins and the distractor was removed in the outpatient clinic. The stabilization period ranges from 8 to 10 weeks. Results: The use of extraoral multidirectional distractor as an external pin fixator was successful in establishing good reduction of the fracture line with stable occlusion without open bites or malocclusion in four patients. One patient showed mild discrepancies of the occlusion that was corrected by spot grinding of the molar teeth in the outpatient clinic. The patients showed good reduction of the comminuted fracture and good functional results without infection. No nerve or root tooth injury was observed. No patients required revision of fixation for malreduction, non-union or malocclusion. Conclusions: The application of extraoral multidirectional distractor as an external pin fixator can be considered as a potentially effective, easy and reliable technique for the reduction of the comminuted mandibular fracture. Further studies to evaluate the efficacy of the extraoral multidirectional distractor as an external pin fixator are recommended on a large number of patients. J Curr Surg. 2014;4(3):86-90 doi: http://dx.doi.org/10.14740/jcs235w