Reduction and Fixation of a Mandibular Angle Fracture Resulting from a Motorcycle Accident: a Clinical Case Report
DOI:
https://doi.org/10.21270/archi.v15i5.6784Palavras-chave:
Mandibular Fractures, Facial Injuries, Fracture Fixation, InternalResumo
Mandibular fractures are among the most common injuries in maxillofacial trauma, generally associated with high-energy accidents, such as motorcycle accidents. Due to its anatomical position and mobility, the mandible is particularly susceptible to direct impacts. The diagnosis of these fractures is based on clinical evaluation combined with imaging studies, with computed tomography (CT) being the gold standard. Treatment varies according to the complexity of the case, with open reduction and internal fixation being widely used because it provides stability and early functional recovery. The aim of this study is to report on a clinical case of a right mandibular angle fracture resulting from a motorcycle accident. A 25-year-old male patient presented with pain, limited mouth opening, edema, and malocclusion. A CT scan confirmed the diagnosis. The surgical procedure was performed under general anesthesia, with reduction and internal fixation of the fracture using two 2.0-system titanium plates and screws, combined with intraoperative maxillomandibular block. The postoperative course was satisfactory, without complications, with progressive improvement in mandibular function. It is concluded that the surgical approach employed proved effective, promoting adequate bone stability and functional recovery, reinforcing its indication for mandibular fractures with displacement.
Downloads
Referências
1. Madeira MC. Anatomia da face: bases anatomofuncionais para a prática odontológica. 8.ed. Rio de Janeiro: Sarvier, 2012.
2. Hupp JR, Ellis E, Tucker MR. Cirurgia oral e maxilofacial contemporânea 6.ed. Rio de Janeiro: Sarvier, 2015.
3. Andrade Filho EF, Fadul Jr R, Azevedo RAA, Rocha MAD, Santos RA, Toledo SR et al. Fraturas de mandíbula: análise de 166 casos. Rev Ass Med Brasil 2000; 46(3): 272-6.
4. Morris C, Bebeau NP, Brockhoff H, Tandon R, Tiwana P. Mandibular fractures: an analysis of the epidemiology and patterns of injury in 4,143 fractures. J Oral Maxillofac Surg. 2015;73(5):951.e1-951.e12.
5. Hassanein AG. Trends and Outcomes of Management of Mandibular Fractures. J Craniofac Surg. 2019;30(4):1245-1251.
6. Lalloo R, Lucchesi LR, Bisignano C, Castle CD, Dingels ZV, Fox JT et al. Epidemiology of facial fractures: incidence, prevalence and years lived with disability estimates from the Global Burden of Disease 2017 study. Inj Prev. 2020;26(Supp 1):i27-i35.
7. Olate S, de Assis AF, Pozzer L, Cavalieri-Pereira L, Asprino L, de Moraes M. Pattern and treatment of mandible body fracture. Int J Burns Trauma. 2013;3(3):164-8.
8. González-García R. Epidemiology of mandibular fractures. Med Oral Patol Oral Cir Bucal 2021;26(2):e199-e205.
9. Alharbi FA, Makrami AM, Ali FM, Maghdi AA. Patterns and Etiology of Maxillofacial Fractures: A 5-year Retrospective Study. J Contemp Dent Pract. 2020;21(4):445-452.
10. Nezam S, Kumar A, Shukla JN, Khan SA. Management of mandibular fracture in pediatric patient. Natl J Maxillofac Surg. 2018;9(1):106-109.
11. Zaheer H, Jafri F, Shaikh AA, Iqbal SS, Jabeen Z, Ali S. Multi center computer guided analysis of site distribution in isolated mandibular fracture. Medical Forum Monthly. 2022; 33(6).
12. Yadav D, Jha A, Mukhi S, Tripathi S, Mishra R, Kandel L. Role of computed tomography in the evaluation of patients with maxillofacial trauma. Mod App Dent Oral Health. 2019;4(1):310-315.
13. Nardi C, Vignoli C, Pietragalla M, Tonelli P, Calistri L, Franchi L, et al. Imaging of mandibular fractures: a pictorial review. Insights Imaging. 2020;11(1):30.
14. Cohen JI, Meyerhoff WL. Mandibular reconstruction: open reduction and internal fixation of mandibular fractures. Otolaryngol Head Neck Surg. 1982;90(5):577-81.
15. Dodson TB, Perrott DH, Kaban LB, Gordon NC. Fixation of mandibular fractures: a comparative analysis of rigid internal fixation and standard fixation techniques. J Oral Maxillofac Surg. 1990;48(4):362-6.
16. Rai A, Karwal V, Nigam S, Saxena A, Sharma M. Outcome Study of Mandibular Fractures Treated by Surgical Stabilization With Plates and Screws. Cureus. 2024;16(4):e58561.
17. Pereira AS, Shitsuka DM, Parreira FJ, Shitsuka R.. Metodologia da pesquisa científica [Scientific Research Methodology] (e-book). Santa Maria Ed. UAB/NTE/UFSM; 2018.
18. Zanata-Pinheiro LH, Silva BB, Kulminare AY, Silva FBC, Basso RCF, Kharmandayan P. Fratura de mandíbula: Análise de 50 casos cirúrgicos em um hospital escola. Rev Bras Cir Plást. 2023;38(4):e0783.
19. Ramalho RA., Araújo FAC, Santos FSM, Caubi AF, Sobreira T. Tratamento de fratura de mandíbula: Miniplacas e parafusos x lag screws – relato de caso. Rev cir traumatol buco-maxilo-fac. 2011;11(1):59-63.
20. Leal OHS, Cavalcante RCL, Pallotta RC, Arcanjo CAP, Santos SF, Lima EK, et al Evolução e avanços nas técnicas de acessos cirúrgicos para tratamento de fraturas de ângulo mandibular. BJIHS. 2026;8(3):1399-1414.
21. Martins Junior JC, Keim FS, Helena ETS. Aspectos epidemiológicos dos pacientes com traumas maxilofaciais operados no Hospital Geral de Blumenau, SC de 2004 a 2009. Arq Int Otorrinolaringol. 2010;14(2):192-98.
22. Lima MVA, Santos Júnior JRL, Holanda MEAM, Nascimento MES, Almeida NMS, Pedrosa Filho CM et al. Techniques for fixing mandibular fractures: An integrative literature review. Res Soc Dev. 2022;11(1), e30511124821.
23. Naeem A, Gemal H, Reed D. Imaging in traumatic mandibular fractures. Quant Imaging Med Surg. 2017;7(4):469-479.
24. Mendes EO, Oliveira Neto AG, Tomes CR, Santos, JL, Feitosa ACR. Tratamento cirúrgico em fratura de mandíbula atrófica: Uma revisão de literatura. Int J Sci Dent. 2022;58(2):2(58):135-145.
25. Antunes PR. Fraturas de mandíbula: revisão de literatura [monografia - Trabalho de Conclusão de Curso]. Lages;Centro Universitário UNIFACVEST; 2020.
26. Miloro M., Ghali GE, Larsen PE, Waite PD. Princípios de cirurgia bucomaxilofacial de Peterson. 3.ed. Grupo GEN; 2016.
27. Dias KB, Vitancort ACF, Costa PAA, Hartel C, Saraiva TBA, Schiefferdecker SA. Etiopathogenesis of pathological mandibular fracture: Literature review and case reports. RGO Rev Gauch Odontol. 2023;71:e20230060.