Citation

Siddiqui SU, Iqbal N, Baig MH, Mehdi H, Mahmood Haider S. Surgeon 2019; ePub(ePub): ePub.

Affiliation

Principal Karachi Medical & Dental College, Consultant OMS Abbasi Shaheed Hospital, Pakistan. Electronic address: mhaider@kmdc.edu.pk.

Copyright

(Copyright © 2019, Royal Colleges of Surgeons of Edinburgh and Ireland)

DOI

10.1016/j.surge.2019.10.004

PMID

31806484

Abstract

INTRODUCTION: Comminuted fractures of the mandible caused by gunshot injuries were traditionally treated with closed reduction using maxillo-mandibular fixation (MMF).^2,3 Open reduction and internal fixation (ORIF) has become a valuable treatment modality in the management of comminuted mandibular fractures due to low rate of complications and predictable healing ^{4, 5}.

OBJECTIVE: To compare the efficacy of ORIF compared with MMF in achieving bony union of comminuted mandibular fractures in gunshot injury patients.

METHOD: ology: Randomized controlled trial conducted at the department of Oral & Maxillofacial Surgery, Abbasi Shaheed Hospital for a period of 3 years; total of 40 patients divided equally into two groups. Group A were treated with ORIF and group B were treated with MMF. Callus formation radiographically was confirmed by 8th week post operatively. Data was collected using proforma, entered on a statistical software SPSS version 20. Frequency percentages were computed for age and gender. Chi square and Fisher's exact tests were applied. P value ≤ 0.05 considered significant.

RESULT: A total of 40 patients of gunshot injuries were included in this study. 37 (92.5%) were males and 3 (7.5%) were Females with mean age of 36.35 ± 12.9 years SD. 19 (47.5%) patients showed callus formation, whereas, 21 (52.5%) did not. Out of 19 patients, 14 (70%) belonged to group A, and 5 (25%) from group B. The final healing considered by 8th week was in 16 (80%) of ORIF group A, and 8 (40%) group B (MMF) after calculating the clinical and radiographic evidences.

CONCLUSION: Comparative clinical trials have proven that ORIF is superior to MMF in the management of comminuted mandibular fractures. Early primary repair and internal fixation provides predictable and cost effective results.

Copyright © 2019 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Language: en

Keywords

Comminuted; Gunshot; Mandible; Maxillo-mandibular fixtion; Open reduction and internal fixation; Oral and maxillofacial Surgery