Top

Oral and Maxillofacial Surgery

Published in:

Open Access 01-06-2019 | Original Article

Accuracy and outcome of mandibular fracture reduction without and with an aid of a repositioning forceps

Authors: Enkh-Orchlon Batbayar, Somaia Malwand, Pieter U. Dijkstra, Ruud R. M. Bos, Baucke van Minnen

Published in: Oral and Maxillofacial Surgery | Issue 2/2019

Abstract

Purpose

It is presumed that adequate reduction of a fracture of the mandible favors bone healing and diminishes the risk of complications. In this retrospective study, we compared the accuracy of fracture alignment and complication rate of mandibular fractures reduced without or with aid of a repositioning forceps.

Methods

Retrospective analysis of consecutive 252 patients with mandibular fractures treated between January 2010 and December 2016. Eligible for this study were patients with isolated mandibular fractures needing open reduction and internal fixation in whom pre- and postoperative radiographs and patient records were available. In total, 131 (252 fractures) patients fulfilled the inclusion criteria.

Results

Seventy-one (54%) patients were men. Mean age of the patients was 33 ± 16.5 years, and the median and interquartile range of age was 25 (20;41). In 54 patients, mandibular fractures were reduced without the aid of repositioning forceps, and in the remaining 77 patients, the fractures were reduced with the aid of the repositioning forceps. Anatomical alignment of the fractures was poor in the non-forceps-aided group (48%) compared to the forceps-aided group (58%) (P = .067). Overall complication rate was higher in the group of fractures reduced without the aid of forceps (17%) than in the forceps-aided group (7%) (P = .045; OR, 2.7; 95% CI, 1.0–7.4).

Conclusions

Mandibular fractures reduced with the aid of repositioning forceps are accompanied by a lower complication rate and better alignment. This is an important observation as better alignment of the fracture fragments favors bone healing and reduces complications.

Mukerji R, Mukerji G, McGurk M (2006) Mandibular fractures: historical perspective. Br J Oral Maxillofac Surg 44:222–228. https://doi.org/10.1016/j.bjoms.2005.06.023 CrossRefPubMed

Choi BH, Kim HJ, Kim MK, Han SG, Huh JY, Kim BY, Zhu SJ, Jung JH (2005) Management of mandibular angle fractures using the mandibular angle reduction forceps. Int J Oral Maxillofac Surg 34:257–261. https://doi.org/10.1016/j.ijom.2004.05.009 CrossRefPubMed

Dimitroulis G (2002) Management of fractured mandibles without the use of intermaxillary wire fixation. J Oral Maxillofac Surg 60:1435–1438. https://doi.org/10.1053/joms.2002.36100 CrossRefPubMed

Bali R, Sharma P, Garg A (2011) Incidence and patterns of needlestick injuries during intermaxillary fixation. Br J Oral Maxillofac Surg 49:221–224. https://doi.org/10.1016/j.bjoms.2010.04.010 CrossRefPubMed

Hashemi HM, Parhiz A (2011) Complications using intermaxillary fixation screws. J Oral Maxillofac Surg 69:1411–1414. https://doi.org/10.1016/j.joms.2010.05.070 CrossRefPubMed

Fordyce a M, Lalani Z, Songra AK et al (1999) Intermaxillary fixation is not usually necessary to reduce mandibular fractures. Br J Oral Maxillofac Surg 37:52–57. https://doi.org/10.1016/S0278-2391(00)80039-7 CrossRefPubMed

Bell RB, Wilson DM (2008) Is the use of arch bars or interdental wire fixation necessary for successful outcomes in the open reduction and internal fixation of mandibular angle fractures? J Oral Maxillofac Surg 66:2116–2122. https://doi.org/10.1016/j.joms.2008.05.370 CrossRefPubMed

Laurentjoye M, Majoufre-Lefebvre C, Caix P, Siberchicot F, Ricard AS (2009) Treatment of mandibular fractures with Michelet technique: manual fracture reduction without arch bars. J Oral Maxillofac Surg 67:2374–2379. https://doi.org/10.1016/j.joms.2009.04.100 CrossRefPubMed

Hsu E, Crombie A, To P et al (2012) Manual reduction of mandibular fractures before internal fixation leads to shorter operative duration and equivalent outcomes when compared with reduction with intermaxillary fixation. J Oral Maxillofac Surg 70:1622–1626. https://doi.org/10.1016/j.joms.2012.03.012 CrossRefPubMed

10.

Kluszynski BA, Wineland AM, Kokoska MS (2007) Mechanical and clinical rationale of prototype bone reduction forceps. Arch Facial Plast Surg 9:106–109. https://doi.org/10.1001/archfaci.9.2.106 CrossRefPubMed

11.

Saman M, Kadakia S, Ducic Y (2014) Postoperative maxillomandibular fixation after open reduction of mandible fractures. JAMA Facial Plast Surg 16:410–413. https://doi.org/10.1001/jamafacial.2014.543 CrossRefPubMed

12.

Davison SP, Clifton MS, Davison MN, Hedrick M, Sotereanos G (2001) Pediatric mandibular fractures: a free hand technique. Arch Facial Plast Surg 3:185–189; discussion 190CrossRefPubMed

13.

Batbayar E-O, van Minnen B, Bos RRM (2017) Non-IMF mandibular fracture reduction techniques: a review of the literature. J Cranio-Maxillofac Surg 45:1327–1332. https://doi.org/10.1016/j.jcms.2017.05.017 CrossRef

Title: Accuracy and outcome of mandibular fracture reduction without and with an aid of a repositioning forceps
Authors: Enkh-Orchlon Batbayar
Somaia Malwand
Pieter U. Dijkstra
Ruud R. M. Bos
Baucke van Minnen
Publication date: 01-06-2019
Publisher: Springer Berlin Heidelberg
Published in: Oral and Maxillofacial Surgery / Issue 2/2019
Print ISSN: 1865-1550
Electronic ISSN: 1865-1569
DOI: https://doi.org/10.1007/s10006-019-00759-0

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Accuracy and outcome of mandibular fracture reduction without and with an aid of a repositioning forceps

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 2/2019

Twenty four years of oral and maxillofacial surgery malpractice claims in Spain: patient safety lessons to learn

Tridimensional virtual planning protocol for double-jaw orthognathic surgery with mandible first surgical sequence

Case report: chronic inflammatory ulcer and osteoradionecrosis of the skull following radiotherapy in early childhood

The presentation of odontogenic keratocysts in the jaws with an emphasis on the tooth-bearing area: a systematic review and meta-analysis

Anteroposterior and vertical soft tissue cephalometric norms of Iranians, interethnic comparisons, sex dimorphism, and the effect of age on cephalometric variables

A radiologic evaluation of the incidence and morphology of maxillary sinus septa in Japanese dentate maxillae