Refracture and Realignment of a Malunited Mandibular Fracture: A Case Report

Abstract

The main goal of reconstructing mandibular fractures is achieving high stability at the fracture lines as well as prevention of possible complications. Recent studies have evaluated the post-operative complications of reduction and fixation of mandibular fractures; nonunion, malunion, infection, wound dehiscence and metal failure (in cases of open reduction and internal fixation (ORIF). Risk factors which could contribute in the formation of such complications include; panfacial fractures, external wound severity, incisional approach, premature restoration of full masticatory functions as well as general conditions deferring the healing process e.g., diabetes mellitus, immunosuppressive drugs and alcoholism. Our article is devoted to discuss the outcomes of reconstruction of an old malunited mandibular fracture in a 28-years-old male patient by refracture and re-stabilization using intermaxillary mandibular fixation (IMF). The management plan takes inconsideration restorion of normal occlusion, stability at the fracture lines, and preventing the risk factors that lead to the fracture malunion and malocclusion. This strategy, which emphasized a multidisciplinary approach combining surgical competence and patient-specific factors, had positive results accomplishing anatomical reduction and mastication with positive results. The Post-operative anatomy, with proper occlusion enabled the patient to tolerate a normal diet with no complications.