Surgical Management of Non-Union Edentulous Mandibular Fracture: A Case Report

Introduction: Management of the atrophic mandibular fracture is a common challenge among maxillofacial surgeons. This is related to anatomic and physiologic changes in the elderly patients. As a member of trauma team, a maxillofacial surgeon should have a good knowledge in management of maxillofacial trauma in this group of patients. The treatment options are not unique, but open reduction is more common than closed reduction in the last decade. The purpose of this study is to describe a complication of surgical treatment of an edentulous mandibular fracture and management of this situation. Case Report: A patient with a previous bilateral mandibular body fracture that treated surgically with open reduction and rigid internal fixation with the use of mini-plates and titanium mesh presented with a fistula and mesh exposure after 5 months. The nonunion was occurred at the site of fracture in right side of the mandible. This condition was managed surgically with removal of fixation devices and debridement of all fibrous and necrotic tissues and placement of a reconstruction plate to maintain the anatomical position of the segments. Layered closure of soft tissues with development of a platysmal flap and buccal fat pad flap over the reconstruction plate was done. With a 39 months period of follow up the soft tissue healing and jaw relationship was satisfactory. Conclusion: With regard to this paper, a good anatomical reduction and rigid fixation of the edentulous mandibular fracture can provide successful results. For this purpose we can use the reconstruction plate to get the better stability and reduce the possible movements between segments that can lead to nonunion and infection at the site of fracture