Craniomaxillofacial Trauma & Reconstruction

4 pages, 213 KiB

Open AccessCase Report

Lower Face Asymmetry: Can We Distract the Mandibular Lower Border?

by Santhosh Rao and Sruthi Rao

Craniomaxillofac. Trauma Reconstr. 2015, 8(4), 341-344; https://doi.org/10.1055/s-0034-1395386 - 24 Nov 2015

Orthognathic surgery and alloplastic grafting are the main stay in management in hemifacial microsomia. Distraction osteogenesis is used to increase the ramus and corpus length in the management, but here we have described a technique to increase the height of the body of [...] Read more.

Orthognathic surgery and alloplastic grafting are the main stay in management in hemifacial microsomia. Distraction osteogenesis is used to increase the ramus and corpus length in the management, but here we have described a technique to increase the height of the body of the mandible using the principles of basal osteotomy and distraction osteogenesis. Full article

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1 pages, 32 KiB

Open AccessCorrection

Computer-Assisted Three-Dimensional Planning for Orbital Decompression

by Srinivas Murthy Susarla, Michael Grant, Shannath Merbs and Nicholas Mahoney

Craniomaxillofac. Trauma Reconstr. 2015, 8(4), 375; https://doi.org/10.1055/s-0035-1564297 - 23 Sep 2015

Cited by 1

Abstract

The publisher regrets an error with the order of the author names in the above article in Craniomaxillofacial Trauma & Reconstruction, Volume 8, Number 3, 2015. p. 211. The corrected order is indicated above [...] Full article

5 pages, 338 KiB

Open AccessCase Report

Orbital Floor Fracture with Atypical Extraocular Muscle Entrapment Pattern and Intraoperative Asystole in an Adult

by Farhan I. Merali, Michael P. Grant and Nicholas R. Mahoney

Craniomaxillofac. Trauma Reconstr. 2015, 8(4), 370-374; https://doi.org/10.1055/s-0035-1556052 - 19 Jun 2015

Cited by 5

Abstract

Extraocular muscle entrapment in a nondisplaced orbital fracture, although a wellknown entity in pediatric trauma, is atypical in adults. It can present with a triad of bradycardia, nausea, and in rare cases, syncope, and result in severe fibrosis of damaged and incarcerated muscle. [...] Read more.

Extraocular muscle entrapment in a nondisplaced orbital fracture, although a wellknown entity in pediatric trauma, is atypical in adults. It can present with a triad of bradycardia, nausea, and in rare cases, syncope, and result in severe fibrosis of damaged and incarcerated muscle. We present a case of muscle entrapment in a partially nondisplaced two-wall orbital fracture with accompanying preoperative bradycardia and intraoperative asystole in an adult. Full article

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7 pages, 391 KiB

Open AccessArticle

Remodeling of Displaced Condylar Fractures with Functional Treatment: High-Quality Radiographic Documentation in Three-Patient Series

by Yavuz Yildirim and Eugene E. Keller

Craniomaxillofac. Trauma Reconstr. 2015, 8(4), 334-340; https://doi.org/10.1055/s-0035-1550064 - 30 Apr 2015

Cited by 3

Abstract

Treatment of condylar fractures is variable and controversial. Treatment options for management of condylar fractures include surgical and nonsurgical methods, and if a nonsurgical method is as effective as a surgical method, the former is preferred. Although plain film radiographs and functional outcomes [...] Read more.

Treatment of condylar fractures is variable and controversial. Treatment options for management of condylar fractures include surgical and nonsurgical methods, and if a nonsurgical method is as effective as a surgical method, the former is preferred. Although plain film radiographs and functional outcomes attained through nonsurgical treatment are well established in literature, evidence of the remodeling process through detailed, high-quality imaging is lacking. The purpose of this case series is to describe and illustrate two adults and one pediatric patient with significantly displaced condylar fractures treated nonsurgically with excellent clinical results. It is unique for such patients to have pre- and posttreatment computed tomography scans with high-quality three-dimensional reconstruction as in the case of two adults and to have 3.5-year posttrauma radiographs and 14.5-year follow-up as in the case of the pediatric patient. As such, this report is useful in visually presenting three examples of repositioning and reformation of the temporomandibular joint structures in displaced condylar fractures in a postmenarche 14-year-old female patient, a 21-year-old male patient, and an 18- month-old male patient. Full article

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7 pages, 568 KiB

Open AccessCase Report

Complete Midline Cleft of Lower Lip, Mandible, Tongue, Floor of Mouth with Neck Contracture: A Case Report and Review of Literature

by Anantheswar Y. N. Rao

Craniomaxillofac. Trauma Reconstr. 2015, 8(4), 363-369; https://doi.org/10.1055/s-0035-1549013 - 28 Apr 2015

Cited by 13

Abstract

Midline cleft of the lower lip and mandible is an extremely rare condition. Since 1819, when the first case was reported by Couronne, fewer than 80 cases have been described in the world literature so far. The cleft has also been described as [...] Read more.

Midline cleft of the lower lip and mandible is an extremely rare condition. Since 1819, when the first case was reported by Couronne, fewer than 80 cases have been described in the world literature so far. The cleft has also been described as facial cleft no. 30 by Paul Tessier. The condition varies in severity from a mild variety in which there is a submucous cleft and notching in the lower lip to a severe variety, involving the tongue, floor of themouth, mandible, absent hyoid, atrophic neckmuscles, and sternum. In this case report, a female child having complete midline cleft of the lower lip and mandible, with bifid tongue stuck to the floor of the mouth, absent hyoid bone and flexion contracture band extending from the confluence of the tip of the tongue, floor of the mouth, cleft mandible to the manubrium sterni is described, with special emphasis on surgical planning and management. Full article

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8 pages, 387 KiB

Open AccessArticle

Treatment of Orbital Medial Wall Fractures with Titanium Mesh Plates Using Retrocaruncular Approach: Outcomes with Different Techniques

by Giovanni Gerbino, Emanuele Zavattero, Stefano Viterbo and Guglielmo Ramieri

Craniomaxillofac. Trauma Reconstr. 2015, 8(4), 326-333; https://doi.org/10.1055/s-0035-1549014 - 28 Apr 2015

Cited by 14

Abstract

Surgical management of medial wall orbital fractures should be considered to avoid diplopia and posttraumatic enophthalmos. Treatment of these fractures remains a challenge for the maxillofacial surgeon because of complex anatomy and limited vision. This article aims to retrospectively evaluate the outcomes in [...] Read more.

Surgical management of medial wall orbital fractures should be considered to avoid diplopia and posttraumatic enophthalmos. Treatment of these fractures remains a challenge for the maxillofacial surgeon because of complex anatomy and limited vision. This article aims to retrospectively evaluate the outcomes in the repair of medial orbital wall fractures using a retrocaruncular approach and titanium meshes, comparing the placement of the titanium mesh with three different techniques: (1) conventional free hand under direct vision, (2) with the assistance of an endoscope, and (c) with the assistance of a navigation system. Eighteen patients who underwent surgery for orbital medial wall fracture were enrolled in the study. On the basis of the implant placement technique, three groups were identified: group 1 (CONV), conventional free hand under direct vision; group 2 (ENDO), endoscopically assisted; group 3 (NAVI), a navigational system assisted (BrainLab, Feldkirchen, Germany). The postoperative quality of orbital reconstruction was assessed as satisfactory in 12 cases, good in 4 cases, and unsatisfactory in 2 cases. Particularly in group 1 (CONV) in four patients out of eight, the posterior ledge of the fracture was not reached by the implant and in one patient the mesh hinged toward the ethmoid. In group 3 (NAVI), in one patient out of five, the posterior ledge of the fracture was not reached. In conclusion, titanium orbital mesh plates and retrocaruncular approach are a reliable method to obtain an accurate orbital medial wall reconstruction. The use of endoscopic assistance through the surgical incisions improves accuracy of treatment allowing better visualization of the surgical field. Navigation aided surgery is a feasible technique especially for complex orbital reconstruction to improve predictability and outcomes in orbital repair. Full article

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5 pages, 148 KiB

Open AccessArticle

Maxillofacial Fractures Surgically Managed at Aalesund Hospital Between 2002 and 2009

by Espen Helgeland, Ida Marie Dahle, Jan Inge Leira and Lado Lako Loro

Craniomaxillofac. Trauma Reconstr. 2015, 8(4), 321-325; https://doi.org/10.1055/s-0035-1550062 - 28 Apr 2015

Cited by 6

Abstract

This study analyses the demographics, etiology, and complications in patients operated for maxillofacial fractures by oral and maxillofacial surgeons at the Aalesund Hospital between 2002 and 2009. A total of 188 fractures in 139 patientswere studied. The maleto- female ratio was 3.6:1 and [...] Read more.

This study analyses the demographics, etiology, and complications in patients operated for maxillofacial fractures by oral and maxillofacial surgeons at the Aalesund Hospital between 2002 and 2009. A total of 188 fractures in 139 patientswere studied. The maleto- female ratio was 3.6:1 and the mean age was 35.7 ± 17.2 years. Males were significantly younger than females (p < 0.05). Mandibular (52.7%) and zygomatic complex fractures (33.5%) were the most frequent. Most patients (41.7%) sustained their injuries as a result of interpersonal violence (IPV) followed by falls (25.9%) and traffic accidents (15.8%). Significantly more males were victims of IPV (p < 0.05). Almost half of the female cohort sustained their injuries from falling. More than half of those who sustained their injuries betweenmidnight andmorning were intoxicated. The majority of cases were treated by open reduction and internal fixation (56.8%). Posttraumatic and postoperative complications were seen in 25% of the patients, with infection (8.6%) occurring most frequently. Mandibular and zygomatic complex fractures were the most frequent in our study. IPV in association with alcohol and drugs was a major cause of maxillofacial fractures, especially among young adult males. Falls were the predominant cause of fractures among females. Full article

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6 pages, 219 KiB

Open AccessArticle

Minimizing the Submandibular Incision in Endoscopic Subcondylar Fracture Repair

by Yasser Abdallah Aboelatta, Amir S. Elbarbary, Sarah Abdelazeem, Karim S. Massoud and Ikram I. Safe

Craniomaxillofac. Trauma Reconstr. 2015, 8(4), 315-320; https://doi.org/10.1055/s-0035-1549010 - 30 Mar 2015

Cited by 9

Abstract

Endoscope-assisted treatment of mandibular condylar fractures is an evolving surgical technique of this controversial subject. The approach is performed through an intraoral and additional submandibular incision. This study presents a technique for minimizing the length of the optional submandibular incision. Ten patients with [...] Read more.

Endoscope-assisted treatment of mandibular condylar fractures is an evolving surgical technique of this controversial subject. The approach is performed through an intraoral and additional submandibular incision. This study presents a technique for minimizing the length of the optional submandibular incision. Ten patients with displaced subcondylar fractures andmalocclusion underwent endoscope-assisted open reduction and internal fixation (ORIF). A limited (<1 cm) submandibular incision (dissected under endoscopic guidance from within) was needed in eight patients to complement the intraoral incision and facilitate the reduction in the fractures. Satisfactory small scar could be obtained in all patients with neither wound complications nor facial nerve injuries. Our technique depends on dissection first then incision. Performing the external incision after complete intraoral dissection is safe for the facial nerve and minimizes scarring markedly. This very limited submandibular incision facilitates reduction in relatively difficult cases and enables clear visualization of posterior border of the mandible to confirm adequate fracture reduction. Full article

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8 pages, 289 KiB

Open AccessArticle

Analysis of 1545 Fractures of Facial Region—A Retrospective Study

by Rajasekhar Gaddipati, Sudhir Ramisetti, Nandagopal Vura, K. Rajiv Reddy and Bhargav Nalamolu

Craniomaxillofac. Trauma Reconstr. 2015, 8(4), 307-314; https://doi.org/10.1055/s-0035-1549015 - 27 Mar 2015

Cited by 24 | Viewed by 85

Abstract

Incidence and etiology of facial fractures vary from region to region due to various constituents. This study was carried to evaluate the patterns and distribution of fractures in the facial region among different age groups of patients in both males and females caused [...] Read more.

Incidence and etiology of facial fractures vary from region to region due to various constituents. This study was carried to evaluate the patterns and distribution of fractures in the facial region among different age groups of patients in both males and females caused due to various etiologies. This is a retrospective epidemiological study, which was performed on patients with fractures in themaxillofacial region during a period of 2005 to 2013 at Mamata Dental College and Hospital, Khammam, India. A total of 1015 patients with 1545 fractures were referred for treatment to department of oral and maxillofacial injuries surgery, of Mamata Dental College and Hospital, with a mean age of 31.19. The ratio of males (859):females (156) is 5.5:1. Injuries caused by motorbike injuries (34.9%) are highest. The highest frequency of fractures caused by various reasons is seen more in third decade (39%). Mandible (43.81%) is the most common fracture site in the face. Among soft tissue injuries most commonly seen are lacerations (43%). This study differentiates the etiological factors causing facial trauma in several age groups. Results of this study suggest outcomes indicate that more reliance on individual transport on motor vehicles has increased the frequency of facial bone fractures. Regardless of age, motor vehicle accidents were high in all age groups except the first decade of life and above 60 years of age when traffic accidents dominated. Thus effectiveness of current preventive measures is to be assessed, followed by instituting new guidelines for prevention and inflexible traffic rules shall be levied.More epidemiological surveys can, if encouraged tomeasure the frequency of fractures, better the world. Full article

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7 pages, 478 KiB

Open AccessCase Report

Penetrating Orbital-Cranial Injuries Management in a Limited Resource Hospital in Latin America

by Glyn Estebanez, Diana Garavito, Laura López, Juan Carlos Ortiz and Andrés M. Rubiano

Craniomaxillofac. Trauma Reconstr. 2015, 8(4), 356-362; https://doi.org/10.1055/s-0035-1546813 - 20 Feb 2015

Cited by 14

Abstract

Penetrating orbital-cranial injuries (POCIs) are difficult cases especially in hospitals in low-middle-income countries (LMIC) where resources are limited. We present a case series of POCI managed in a university hospital in such scenario. A retrospective case series was conducted including patients with POCI [...] Read more.

Penetrating orbital-cranial injuries (POCIs) are difficult cases especially in hospitals in low-middle-income countries (LMIC) where resources are limited. We present a case series of POCI managed in a university hospital in such scenario. A retrospective case series was conducted including patients with POCI in 2011. Mechanism of injury, Glasgow Coma Scale score, imaging, medical and surgical management, complications, and Glasgow Outcome Scale (GOS) score were analyzed. A total of 30 patients with penetrating orbital injuries were admitted from March 2011 to December 2011. Of this group, only four patients were diagnosed with cranial penetration. Computed tomography (CT) angiography revealed orbital fractures and injury to frontal, temporal, or occipital lobes. Urgent craniotomy with isolation of ipsilateral carotid artery was performed. GOS score at discharge was 5 in three patients and 4 in one patient. POCIs are not uncommon in hospitals of LMIC. In such scenarios, a standard approach with CT angiography and early neurosurgical intervention results in good outcome. Full article

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4 pages, 257 KiB

Open AccessCase Report

Application of Maxillomandibular Fixation for Management of Traumatic Macroglossia: A Case Report

by Rabie M. Shanti, Hani F. Braidy and Vincent B. Ziccardi

Craniomaxillofac. Trauma Reconstr. 2015, 8(4), 352-355; https://doi.org/10.1055/s-0035-1546815 - 18 Feb 2015

Cited by 3 | Viewed by 68

Abstract

We present a case of a 14-year-old adolescent boy who has oral cavity after gunshot wound to the tongue presenting with hemorrhage from the tongue requiring coil embolization of the right lingual artery. The patient subsequently developed macroglossia, which was managed with maxillomandibular [...] Read more.

We present a case of a 14-year-old adolescent boy who has oral cavity after gunshot wound to the tongue presenting with hemorrhage from the tongue requiring coil embolization of the right lingual artery. The patient subsequently developed macroglossia, which was managed with maxillomandibular fixation for a period of 3 weeks with complete resolution of glossal edema. Full article

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8 pages, 149 KiB

Open AccessArticle

An Evaluation of the Effect of Therapeutic Ultrasound on Healing of Mandibular Fracture

by Kiran Patel, Sanjeev Kumar, Nishtha Kathiriya, Sonal Madan, Ankit Shah, Karthik Venkataraghavan and Mehul Jani

Craniomaxillofac. Trauma Reconstr. 2015, 8(4), 299-306; https://doi.org/10.1055/s-0034-1544104 - 5 Feb 2015

Cited by 13

Abstract

The mandible is the most frequently fractured bone in maxillofacial trauma, the treatment of which consists of reduction and fixation of dislocated fragments by open or closed approach. Innovative techniques toward reducing the period of the postoperative intermaxillary fixation (IMF) are being researched. [...] Read more.

The mandible is the most frequently fractured bone in maxillofacial trauma, the treatment of which consists of reduction and fixation of dislocated fragments by open or closed approach. Innovative techniques toward reducing the period of the postoperative intermaxillary fixation (IMF) are being researched. A relatively unknown treatment thatmay have an effect on fracture healing is ultrasound. Recent clinical trials have shown that lowintensity pulsed ultrasound (LIPUS) has a positive effect on bone healing. The aim of this study was to evaluate the effect of LIPUS on healing by its application in fresh, minimally displaced or undisplaced mandibular fracture in young and healthy individuals. A total of 28 healthy patients were selected randomly from the outpatient department needing treatment of mandibular fractures. They were then randomly allocated to either of the following two groups—experimental group and study group. After IMF, patients in experimental group received pulsed ultrasound signals with frequency of 1 MHz, with temporal and spatial intensity of 1.5 W/cm², pulsed wave for 5 minutes on every alternate day for 24 days, whereas patients in control group received no therapy except IMF. Radiographic density at the fracture zone was assessed from the radiograph by Emago (Emago, Amsterdam, Netherlands) Image Analysis software before IMF then at 1st to 5th weeks post-IMF. The amount of clinical mobility between fracture fragments was assessed by digital manipulation of fractured fragment with the help of periodontal pocket depth measuring probe in millimeters at pre-IMFand after 3 weeks. Pain was objectivelymeasured using a visual analogue scale at weekly interval. The data collected were subjected to unpaired “t” test. The experimental group showed significant improvement in radiographic density compared with control group at 3- and 5-week interval; pain perception was significantly reduced in experimental group compared with study group in the subsequent weeks. No significant difference was found in clinical mobility between fracture fragments at 3-week interval. The present study provides a basis for application of therapeutic controlled ultrasound as an effective treatment modality to accelerate healing of fresh, minimally displaced mandibular fracture. Full article

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10 pages, 400 KiB

Open AccessArticle

A Protocol to Reduce Interobserver Variability in the Computed Tomography Measurement of Orbital Floor Fractures

by Chuan Han Ang, Jin Rong Low, Jia Yi Shen, Elijah Zheng Yang Cai, Eileen Chor Hoong Hing, Yiong Huak Chan, Gangadhara Sundar and Thiam Chye Lim

Craniomaxillofac. Trauma Reconstr. 2015, 8(4), 289-298; https://doi.org/10.1055/s-0034-1399800 - 3 Feb 2015

Cited by 12 | Viewed by 73

Abstract

Orbital fracture detection and size determination from computed tomography (CT) scans affect the decision to operate, the type of surgical implant used, and postoperative outcomes. However, the lack of standardization of radiological signs often leads to the false-positive detection of orbital fractures, while [...] Read more.

Orbital fracture detection and size determination from computed tomography (CT) scans affect the decision to operate, the type of surgical implant used, and postoperative outcomes. However, the lack of standardization of radiological signs often leads to the false-positive detection of orbital fractures, while nonstandardized landmarks lead to inaccurate defect measurements. We aim to design a novel protocol for CT measurement of orbital floor fractures and evaluate the interobserver variability on CT scan images. Qualitative aspects of this protocol include identifying direct and indirect signs of orbital fractures on CT scan images. Quantitative aspects of this protocol include measuring the surface area of pure orbital floor fractures using computer software. In this study, 15 independent observers without clinical experience in orbital fracture detection and measurement measured the orbital floor fractures of three randomly selected patients following the protocol. The time required for each measurement was recorded. The intraclass correlation coefficient of the surface area measurements is 0.999 (0.997–1.000) with p-value < 0.001. This suggests that any observer measuring the surface area will obtain a similar estimation of the fractured surface area. The maximum error limit was 0.901 cm² which is less than the margin of error of 1 cm² in mesh trimming for orbital reconstruction. The average duration required for each measurement was 3 minutes 19 seconds (ranging from 1 minute 35 seconds to 5 minutes). Measurements performed with our novel protocol resulted in minimal interobserver variability. This protocol is effective and generated reproducible results, is easy to teach and utilize, and its findings can be interpreted easily. Full article

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4 pages, 390 KiB

Open AccessCase Report

Le Fort I Approach for Midline Tumors of the Palate

by Jorge Guiñales Díaz de Cevallos, Jose L. Cebrián Carretero, Jose L. Del Castillo Pardo de Vera and Miguel Burgueño García

Craniomaxillofac. Trauma Reconstr. 2015, 8(4), 348-351; https://doi.org/10.1055/s-0034-1399798 - 22 Jan 2015

Cited by 3

Abstract

Midline tumors of the palate may represent a challenge for the maxillofacial surgeon. Their resection and immediate reconstruction could be hindered when a simply intraoral approach is selected. The Le Fort I downfracture approach represents an ideal technique for the management of this [...] Read more.

Midline tumors of the palate may represent a challenge for the maxillofacial surgeon. Their resection and immediate reconstruction could be hindered when a simply intraoral approach is selected. The Le Fort I downfracture approach represents an ideal technique for the management of this tumors, simplifying their resection, ensuring a tumor-free margin, and allowing their reconstruction with a temporal muscle flap. A review of this procedure is presented, highlighting the technical keys and its principal advantages. Full article

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8 pages, 330 KiB

Open AccessArticle

Trend and Characteristics of 2636 Maxillofacial Fracture Cases over 32 Years in Suburban City of Japan

by Kazuhiko Yamamoto, Yumiko Matsusue, Satoshi Horita, Kazuhiro Murakami, Tsutomu Sugiura and Tadaaki Kirita

Craniomaxillofac. Trauma Reconstr. 2015, 8(4), 281-288; https://doi.org/10.1055/s-0034-1399797 - 16 Jan 2015

Cited by 6 | Viewed by 54

Abstract

Trend and characteristics of maxillofacial fractures in 2636 patients over 32 years were analyzed retrospectively. Patients comprised 1764 males and 872 females with ages ranging from 0 to 99 years. Patients younger than 30 years consisted of 60% maxillofacial fractures in the early [...] Read more.

Trend and characteristics of maxillofacial fractures in 2636 patients over 32 years were analyzed retrospectively. Patients comprised 1764 males and 872 females with ages ranging from 0 to 99 years. Patients younger than 30 years consisted of 60% maxillofacial fractures in the early period but decreased to 40% in the late period. In contrast, patients older than 60 years gradually increased to 30%. In terms of cause, traffic accidents consisted of more than 50%, predominantly motorcycle accidents, but gradually decreased to 40%. In contrast, falls markedly increased from less than 10 to 30%. Fractures occurred in the midface in 938 patients, in the mandible in 1490, and in both in 208. In the midface, zygoma fractures consisted of 50% throughout the period. In the mandible, condyle fractures were observed in 40%, followed by fractures of the symphysis and angle. The ratio of condylar fractures slightly increased. Open reduction and internal fixation (ORIF) were performed in 782 patients, followed by observation in 716, maxillomandibular fixation (MMF) in 605, intramaxillary splinting (IMS) in 294, transcutaneous reduction (TCR) in 126, and others in 113. MMF markedly decreased from more than 30 to less than 5% and observation increased from 20 to 40%. Full article

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3 pages, 201 KiB

Open AccessCase Report

Medial Wall Fracture and Orbital Emphysema Mimicking Inferior Rectus Entrapment in a Child

by John Collin, Farid Afshar and Steven Thomas

Craniomaxillofac. Trauma Reconstr. 2015, 8(4), 345-347; https://doi.org/10.1055/s-0034-1399802 - 14 Jan 2015

Cited by 3

Abstract

Orbital emphysema is commonly associated with fractures of the orbital floor or medial wall. The air often dissipates spontaneously, but rarely can cause increased intraocular pressure and even loss of vision. Entrapment of the extraocular muscles can also occur with orbital fractures and [...] Read more.

Orbital emphysema is commonly associated with fractures of the orbital floor or medial wall. The air often dissipates spontaneously, but rarely can cause increased intraocular pressure and even loss of vision. Entrapment of the extraocular muscles can also occur with orbital fractures and may require prompt treatment in the pediatric patient due to the risk muscle ischemia. Both conditions can cause diplopia due to restriction of eye movement and differentiation of the two etiologies is important to prevent unnecessary surgical exploration. Identification and prompt management of raised intraocular pressure is essential in patients with orbital trauma. We present a case of orbital emphysema mimicking inferior rectus entrapment following trauma in an 11-year-old boy. Full article

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4 pages, 76 KiB

Open AccessArticle

Does Extraction or Retention of the Wisdom Tooth at the Time of Surgery for Open Reduction and Internal Fixation of the Mandible Alter the Patient Outcome?

by Douglas Hammond, Sat Parmar, Justin Whitty and Nick Pigadas

Craniomaxillofac. Trauma Reconstr. 2015, 8(4), 277-280; https://doi.org/10.1055/s-0034-1399796 - 14 Jan 2015

Cited by 7 | Viewed by 73

Abstract

Whether to extract or retain wisdom teeth present in a fracture line is a controversial topic. This study reviewed the records of all patients who had mandibular wisdom teeth at the time of the injury, and had an open reduction and internal fixation [...] Read more.

Whether to extract or retain wisdom teeth present in a fracture line is a controversial topic. This study reviewed the records of all patients who had mandibular wisdom teeth at the time of the injury, and had an open reduction and internal fixation procedure between January 2009 and January 2012. The cohort of patients who concomitantly had their wisdom tooth extracted at the time of fixation had a greater complication rate (24.3%) compared with patients who did not (14.9%). This suggests that if third molars in the line of a fracture have caries, are fractured, show signs of pericoronitis, are periodontally involved, or are interfering with the occlusion are extracted at the time of fixation, this will increase the incidence of complications. Full article

6 pages, 216 KiB

Open AccessArticle

Orbitozygomatic Fracture Repairs: Are Antibiotics Necessary?

by Weber Huang, Anthony Lynham and Martin Wullschleger

Craniomaxillofac. Trauma Reconstr. 2015, 8(4), 271-276; https://doi.org/10.1055/s-0034-1399795 - 14 Jan 2015

Cited by 11 | Viewed by 56

Abstract

Orbitozygomatic fractures are one of the most common maxillofacial injuries encountered. This study aims to investigate and review the management and complications of orbitozygomatic fractures at the Royal Brisbane and Women’s Hospital (RBWH). Specifically the postoperative infection rate will be closely examined to [...] Read more.

Orbitozygomatic fractures are one of the most common maxillofacial injuries encountered. This study aims to investigate and review the management and complications of orbitozygomatic fractures at the Royal Brisbane and Women’s Hospital (RBWH). Specifically the postoperative infection rate will be closely examined to determine whether adjunctive antibiotics are necessary in its surgical management. A retrospective case selection study of all patients with orbitozygomatic fractures treated at the RBWH in 2011 was performed. The cases were collected from the maxillofacial database. Chart review of the admission with consecutive follow-up of up to 6 weeks including clinical and radiological assessment and consecutive data analysis was performed. A total of 160 patients with orbitozygomatic fractures were managed at the RBWH with three complications. Eighty-five (53.1%) cases were treated surgically and 155 (97.5%) cases had follow-up until 6 weeks postoperatively. Twenty-six surgical cases (16.3%) were treated via elevation without fixation. A further 26 surgical cases (16.3%) were treated with one fixation point, 19 cases (11.9%) with two fixation points, 12 cases (7.5%) with three fixation points, and 2 cases (1.3%) treated with four fixation points. The three complications (1.9%) returned for surgical correction without further consequence; two were due to inadequate cosmesis and one was due to exposure of the fixation plate. No early postoperative infections were seen. This study presents an excellent outcome with minimal early complications of orbitozygomatic fractures treated at the RBWH, a trauma center with high caseload. All operatively treated cases received perioperative antibiotic prophylaxis as per the unit’s protocol. With a nil infection rate at the RBWH, future studies should focus on whether the use of prophylactic antibiotics is appropriate. Full article

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Craniomaxillofac. Trauma Reconstr., Volume 8, Issue 4 (December 2015) – 18 articles

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