Skip to content

Mandible Fractures: The Role of External Fixation

Mandible fractures, or fractures of the lower jawbone, are a common type of facial fracture that can result from various causes, such as trauma, accidents, or sports injuries. These fractures can have significant functional and aesthetic consequences for the affected individuals. The management of mandible fractures has evolved over the years, with external fixation playing a crucial role in the treatment process. This article aims to explore the role of external fixation in the management of mandible fractures, discussing its benefits, techniques, complications, and outcomes.

The Importance of External Fixation in Mandible Fractures

External fixation is a technique used in the management of mandible fractures to stabilize the fractured bone segments and promote proper healing. It involves the use of external devices, such as plates, screws, wires, or pins, to immobilize the fractured segments and maintain their alignment. This technique is particularly useful in cases where the fracture is complex, comminuted, or associated with soft tissue injuries.

External fixation offers several advantages in the management of mandible fractures:

  • Stability: External fixation provides stability to the fractured bone segments, preventing further displacement and promoting proper alignment for optimal healing.
  • Early mobilization: By stabilizing the fractured segments, external fixation allows for early mobilization of the jaw, reducing the risk of complications such as malocclusion or temporomandibular joint dysfunction.
  • Improved functional outcomes: Proper alignment and stabilization of the fractured segments through external fixation contribute to improved functional outcomes, including normal chewing, speaking, and facial symmetry.
  • Reduced risk of infection: External fixation devices can be easily cleaned and maintained, reducing the risk of infection at the fracture site.

Techniques of External Fixation in Mandible Fractures

There are several techniques of external fixation that can be employed in the management of mandible fractures, depending on the specific characteristics of the fracture and the surgeon’s preference. Some commonly used techniques include:

1. Miniplate Fixation

Miniplate fixation involves the use of small titanium plates and screws to stabilize the fractured segments of the mandible. This technique offers excellent stability and allows for precise alignment of the bone fragments. It is particularly useful in cases of simple fractures or fractures involving the body or angle of the mandible.

Research studies have shown that miniplate fixation provides good functional outcomes and low complication rates in the management of mandible fractures. For example, a study published in the Journal of Oral and Maxillofacial Surgery found that miniplate fixation resulted in a high rate of fracture union and satisfactory functional outcomes in a group of patients with mandible fractures.

2. External Pin Fixation

External pin fixation involves the use of pins or wires inserted through the skin and into the fractured bone segments to stabilize them. This technique is particularly useful in cases where there is limited access to the fracture site or when miniplate fixation is not feasible.

External pin fixation has been shown to be effective in the management of mandible fractures, with studies reporting good fracture union rates and satisfactory functional outcomes. For example, a study published in the Journal of Cranio-Maxillofacial Surgery found that external pin fixation resulted in successful fracture healing and restoration of mandibular function in a group of patients with mandible fractures.

3. Hybrid Fixation

Hybrid fixation involves the combination of different external fixation techniques, such as miniplate fixation and external pin fixation, to achieve optimal stability and alignment of the fractured segments. This technique is particularly useful in cases of complex or comminuted fractures where a single technique may not be sufficient.

Research studies have shown that hybrid fixation can lead to successful fracture healing and good functional outcomes in the management of mandible fractures. For example, a study published in the International Journal of Oral and Maxillofacial Surgery found that hybrid fixation resulted in a high rate of fracture union and satisfactory functional outcomes in a group of patients with complex mandible fractures.

Complications of External Fixation in Mandible Fractures

While external fixation is generally a safe and effective technique in the management of mandible fractures, it is not without its complications. Some potential complications associated with external fixation include:

  • Infection: Despite efforts to maintain proper hygiene and prevent infection, there is still a risk of infection at the site of external fixation. This can lead to delayed healing and other complications.
  • Hardware failure: The plates, screws, wires, or pins used in external fixation can sometimes fail, leading to instability or malalignment of the fractured segments.
  • Soft tissue irritation: The presence of external fixation devices can cause irritation or pressure on the surrounding soft tissues, leading to discomfort or pain.
  • Scarring: External fixation devices may leave visible scars on the skin, particularly in cases where the devices are placed externally.

It is important for surgeons to carefully monitor patients undergoing external fixation for mandible fractures and promptly address any complications that may arise.

Outcomes of External Fixation in Mandible Fractures

The outcomes of external fixation in the management of mandible fractures are generally favorable, with high rates of fracture union and satisfactory functional outcomes reported in research studies. For example, a systematic review published in the Journal of Oral and Maxillofacial Surgery analyzed the outcomes of external fixation in a large group of patients with mandible fractures and found that the overall success rate of fracture union was over 90%.

Furthermore, studies have shown that external fixation can lead to improved functional outcomes and quality of life in patients with mandible fractures. For example, a study published in the Journal of Craniofacial Surgery assessed the functional outcomes and quality of life of patients treated with external fixation for mandible fractures and found significant improvements in chewing ability, speech, and overall satisfaction with appearance and function.

Summary

External fixation plays a crucial role in the management of mandible fractures, offering stability, early mobilization, improved functional outcomes, and reduced risk of infection. Techniques such as miniplate fixation, external pin fixation, and hybrid fixation can be employed depending on the specific characteristics of the fracture. While complications such as infection, hardware failure, soft tissue irritation, and scarring may occur, the overall outcomes of external fixation in mandible fractures are favorable, with high rates of fracture union and satisfactory functional outcomes reported in research studies. It is important for surgeons to carefully monitor patients undergoing external fixation and address any complications promptly. Overall, external fixation is a valuable technique in the management of mandible fractures, contributing to optimal healing and improved quality of life for the affected individuals.

Leave a Reply

Your email address will not be published. Required fields are marked *