[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.
Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Universität Regensburg, Deutschland.
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H
Niederdellmann
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R
Marmulla
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