[Fractures of the edentulous atrophic mandible. Fracture management and complications].
Abteilung für Kiefer- und Gesichtschirurgie, Universitätsklinik für Wiederherstellende Chirurgie, Kantonsspital Basel, Spitalstrasse 21, CH-4031 Basel, Schweiz. Mund- Kiefer- und Gesichtschirurgie
BACKGROUND: With increasing atrophy, fractures of the edentulous mandible tend to have a higher incidence of nonunion. However, the connection between disturbances of bony consolidation and inadequate primary stability is often insufficiently discussed. FIXATION: Rigid internal fixation with 2.7 or now 2.4 AO compression and reconstruction plates is a safe procedure to achieve short-term rehabilitation in the mostly elderly patients by ensuring immediate function without intermaxillary fixation. With increasing atrophy, our concept suggests the use of stronger plates and fixation of screws in safe bony regions far from the fracture site. RESULTS AND DISCUSSION: This study reports the results of treatment of 40 fractures of the edentulous mandible in 25 patients from 1979 until 1996: 38 fractures (95%) showed primary healing, and only 1 nonunion was revealed after fracture of the plate. The criteria for choice of plates are discussed as well as fracture exposure and the question of primary and secondary bone grafting.
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