Case Report
A 35 years old male patient met with sudden severe road accident due to head on collision and lost his consciousness .He was admitted at Intensive Care Unit at Desun Hospitals, Kolkata where proper neurological support and basic health aids were provided.A 3D reconstruction CT Scan of face was conducted. The report revealed that comminuted fracture of anterior mandible with gross malocclusion.
The management for this case was ruled out to perform an Open Reduction and Internal Fixation surgery.1 Open Reduction is a surgical procedure where fracture bone ends are exposed by intraoral or extraoral approach and brought into an alignment . Internal Fixation of mandibular fracture describes the fixation of fractured fragments in their normal anatomical relationship to prevent displacement and achieve proper fixation.Under General Anesthesia , patient underwent Open Reduction and Internal Fixation where external facial wounds at chin regions were modified and extended to get the proper exposure of fracture site. All comminuted bony segments were anatomically reduced and internal fixation was achieved with the application of miniplates to prevent further displacement .Preservation of mental nerves was also achieved on both sides . After 10 days , stitches were removed . There were no signs of non-union or mal-union were found upon close clinical examination. Antibiotic regimen was given to prevent intraoperative and post operative complications. A very satisfactory outcome have been achieved by from both esthetical and functional point of view.
Conclusion
Comminuted fracture is one of the most complicated fracture which requires efficient surgical approach in order to restore normal esthetics and functions of mandible. Comminuted mandbiluar fracture could be treated by various surgical procedure such as closed reduction , external pin fixation , internal wire fixation and open reduction and internal fixation.2 Closed reduction have been considered as the optimal treatment for long period of time because of its preservance of vascularity to comminuted fracture and prevention of secondary infection.3 In our recent times , it have been widely reported across the world that Open Reduction and Internal Fixation surgery is considered as the treatment of choice for comminuted mandible fracture because of its lower complication rate as well fast rehabilitation of oral functions. So, Open Reduction and Internal Fixation Surgery is the most accepted surgical procedure for the cases of comminuted mandibular fractures in order to reconstruct the mandible therefore preserving the esthetics of mandible and also to rehabiliate the basic functions of mandible with minimal possible complications.
