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. 2012 Jun;5(2):91-6.
doi: 10.1055/s-0032-1313364.

The Use of 2.4-mm Locking Plate System in Treating Comminuted Mandibular Fracture by Firearm

Cassiano Costa Silva Pereira  1 , Pâmela Letícia Dos Santos, Ellen Cristina Gaetti Jardim, Idelmo Rangel Garcia Júnior, Elio Hitoshi Shinohara, Marcelo Marotta Araujo
Affiliations

The Use of 2.4-mm Locking Plate System in Treating Comminuted Mandibular Fracture by Firearm

Cassiano Costa Silva Pereira et al. Craniomaxillofac Trauma Reconstr. 2012 Jun.

Abstract

Maxillofacial trauma caused by firearms has considerably increased, in which the mandibular body is the site of highest incidence of firearm projectiles. In these cases, the use of titanium plates and screws allows the early restoration of form and function of the mandible with stable and predictable results. Recently, conventional plates have been extensively used to treat comminuted mandibular fractures. Nevertheless, the conventional system presents several limitations such as screw compression against the bone interface and the necessity of precise fit of plate to the bone. To overcome such drawbacks, the locking plates have emerged. The present clinical case reported the operative treatment of mandibular fracture caused by firearm projectiles with the use of locking plate. The indications, advantages, and disadvantages of this system are presented.

Keywords: firearm; fixation; mandibular fracture; plates.

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Figures

Figure 1
Figure 1
Preoperative: (A) extraoral clinical aspect; (B) intraoral clinical aspect; (C) radiographs of the patient with a comminuted right mandibular body fracture.
Figure 2
Figure 2
Transoperative: (A) extraoral approach of the mandible was used to expose the fracture sites; (B) occlusal pattern restoration; (C) comminuted fracture reduction was performed while keeping the perimeter of the mandibular arch and fixing fracture segments by using plates and screws of the 2.4-mm locking plate system; (D) flap was replaced and sutured in layers.
Figure 3
Figure 3
At 7 days postsurgery, the facial contour and occlusion of the patient were recovered. Radiograph examination revealed proper plate and screws placement with correct basal realignment.
Figure 4
Figure 4
At 6 months postsurgery, total bone and soft tissue healings were noted and no signs of mobility and/or infection in the right mandibular body and occlusal maintenance were observed.
See this image and copyright information in PMC

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