Transbuccal Approach in Management of Mandible Angle Fracture
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ORIGINAL ARTICLE
Transbuccal Approach in Management of Mandible Angle Fracture Bhanu Bhardwaj1 • Jaskaran Singh1,2 • Shveta Mahajan3
Received: 3 June 2020 / Accepted: 8 June 2020 Ó Association of Otolaryngologists of India 2020
Abstract With expanding dimensions and an eminent member of trauma team many Ear Nose Throat specialists are exposed to Oro-maxillofacial trauma. Mandibular angle is a difficult region to operate owing to its unique anatomy. Anglefractures form around 30–40% of the mandibular fracture. Open reduction and internal plating is the management of choice in most angle fractures and various approaches have been described in literature. We conducted a study of trans-buccal approach for management of mandibular angle fractures. It was a non-randomised observational study. 57 patients of mandible angle fractures were included in the study. The ORIF was done in these pts under general anaesthesia after careful surgical planning using trans-buccal approach. This approach included an intraoral exposure with stab incision for the trans-buccal passage of drill and screw diver. Out of 57 cases in our study 33 were males and 24 were females. 23/57 patients were in age group 25–35 years whereas 19/57 patients were in age group 15–25 years All 57 patients had good fracture healing. Occlusion dysfunction was seen in only 1 case. Infection was seen 3 cases while intraoral exposure of & Jaskaran Singh [email protected] Bhanu Bhardwaj [email protected] Shveta Mahajan [email protected] 1
Sri Guru Ram Das University of Health Sciences, 27-C, Sant Avenue, The Mall, Amritsar, Punjab 143001, India
2
Sri Guru Ram Das University of Health Sciences, HIG 202, Sector 71, Mohali, India
3
Health and Family Welfare (UT of J&K), 1 C, Phase 1, Beauty Avenue, Amritsar 143001, India
plates occurred in 2 cases. Average mouth opening was 43.3 mm at 6 weeks with progressive improvement on follow up. Extraoral scar healed well with very good cosmesis in all cases. We strongly suggest the use of transbuccal approach for ORIF in mandibular angle fractures owing to the ease of procedure, comfort of surgeon and less complication rate. Keywords Mandible angle fractures Transbuccal approach Combined approach Extraoral approach Intraoral approach Modified transbuccal approach
Introduction Fractures through the angle of the mandible represent roughly around 30 percent of most common causes of mandibular angle fractures are motor vehicle collisions and assaults. The main reasons for these fractures are the presence of a thinner cross-sectional area relative to the neighbouring segments of the mandible, acute leverage at this region due to the biomechanical consideration of change in angle and the presence of third molars, particularly those that are impacted, thereby weakening the region [1–4]. The angle of mandible is best described as an anatomic region rather than a precise anatomic location. The region is designated as a triangular area with the superior edge being the junction of the horizontal bod
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