[Traumatology. Mandibular fractures excluding condylar fractures].
Functionally stable fixation via bicortical osteosynthesis on the one hand, and monocortical non-compression osteosynthesis on the other, are still two competing concepts in treating mandibular fractures. A survey of the literature shows that complicated fractures with severe dislocation of the fragments have the lowest rate of complications after functionally stable fixation, whereas non-complicated fractures without significant dislocation in the distal part of the mandible can be treated successfully via monocortical non-compressive osteosynthesis as well. It seems that pre- and intraoperative parameters can be helpful in describing the character of a mandibular fracture in order to give a differential indication between the two therapeutical concepts. The consideration of only seven parameters, as the mandibular fracture score does, provides many combinations of describing a fracture, so that former studies with their small number of patients make only a rather inaccurate differential indication possible. As long as there is no prospective multi-center study giving a guideline to classify mandibular fractures, the rigid internal fixation via functionally stable osteosynthesis should be preferred in all cases which are not "clear, easy to handle" fractures.
Niederdellmann
H
H
Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Universität Regensburg, Deutschland.
Marmulla
R
R
D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000601:surgery; D008337:Mandibular Fractures / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery; D011859:Radiography; D012086:Reoperation