📝 “How Can Closed Reduction Treat Different Types of Mandible Fractures?”

8.2.24

Quick Review #194 - #surgery #surgeon #doctorgallagher #oralsurgery #oralsurgeon #omfs #dentist #dentistry #dental #closedreduction

The treatment of mandibular fractures with closed reduction and maxillomandibular fixation (MMF) involves a specific timeline and protocol that varies depending on the fracture location:

General Principles:

1. Initial MMF: Maxillomandibular fixation is used to immobilize the mandible and facilitate healing. The duration of MMF typically ranges from 4 to 6 weeks but can be adjusted based on the fracture’s healing progress and location.

2. Transition from MMF to Elastics:

• Tight Elastics: After an initial period of MMF, tight elastics can be used to allow some mobility while maintaining occlusal alignment. This stage usually begins around 2 to 3 weeks into treatment.

• Light Elastics: As healing progresses, light elastics are introduced, typically around 4 to 5 weeks. This allows more functional movement and encourages the development of normal jaw function.

• Release from MMF: Complete release from MMF and elastics is typically considered after 6 weeks, depending on clinical and radiographic evidence of fracture healing.

Specific Fracture Locations:

1. Symphysis Fractures:

• MMF Duration: 4 to 6 weeks

• Transition: Begin tight elastics at 2 weeks, light elastics at 4 weeks, and release at 6 weeks.

2. Body Fractures:

• MMF Duration: 4 to 6 weeks

• Transition: Tight elastics at 2 to 3 weeks, light elastics at 4 to 5 weeks, release at 6 weeks.

3. Angle Fractures:

• MMF Duration: 4 to 6 weeks

• Transition: Start tight elastics at 2 to 3 weeks, light elastics at 4 to 5 weeks, release at 6 weeks.

4. Ramus Fractures:

• MMF Duration: 4 to 6 weeks

• Transition: Tight elastics at 2 to 3 weeks, light elastics at 4 to 5 weeks, release at 6 weeks.

5. Condylar and Subcondylar Fractures:

• MMF Duration: Often shorter, around 2 to 4 weeks, to prevent ankylosis.

• Transition: Begin early mobilization with light elastics around 2 weeks and gradually increase mobility. Complete release may occur at 4 to 6 weeks, with emphasis on physical therapy and functional rehabilitation.

References:

1. Elias, N., Nish, I. A., & Pynn, B. R. (2019, June 10). Maxillofacial hardware – A review of techniques and radiographic appearance for the general practitioner. Oral Health Group.

2. Ellis, E., & Walker, L. R. (1996). Treatment of mandibular angle fractures using two mini-dynamic compression plates. Journal of Oral and Maxillofacial Surgery, 54(8), 864–869. https://lnkd.in/eztDF4YX

3. Maloney, P. L., & Doku, H. C. (1968). Condylar fractures of the mandible: Part I. Journal of Oral Surgery, 26(8), 457–464.

4. Miloro, M., Ghali, G. E., Larsen, P. E., & Waite, P. D. (Eds.). (2022). Peterson’s principles of oral and maxillofacial surgery (4th ed.). Springer.

5. ChatGPT.2024

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