Autopsy and Case Reports
https://autopsyandcasereports.org/article/doi/10.4322/acr.2014.051
Autopsy and Case Reports
Article / Clinical Case Report

Late treatment of a mandibular gunshot wound

Yuri Slusarenko da Silva; Marcia Maria de Gouveia; Carlos Augusto Ferreira Alves; Rodrigo Chenu Migliolo

Downloads: 10
Views: 368

Abstract

Mandibular gunshot injuries are esthetically and functionally devastating, causing comminuted fractures and adjacent tissue destruction depending on the weapon gauge, projectile shape, impact kinetic energy, and density of the injured structures. If the mandibular fracture is not adequate or promptly treated, the broken fragments will fail to heal. In case of a treatment delay, progressive bone loss and fracture contracture will require a customized approach, which includes open reduction, removal of fibrous tissue between the bony stumps, and fixation of the fracture with a reconstruction plate and autogenous graft. The authors report the case of a 34-year-old man wounded on the mandible 15 years ago. With the aid of computed tomography and a prototype, a surgical plan was designed including open reduction and internal fixation of the segmental mandibular defect with a reconstruction plate and bone graft harvested from the iliac crest. The postoperative follow-up was uneventful and the 12-month follow up showed a positive aesthetic and functional result.
 

Keywords

Wounds, Gunshot, Mandibular Fractures, Jaw Fixation Techniques, Mandibular Reconstruction

References

Rana M, Warraich R, Rashad A, et al. Management of comminuted but continuous mandible defects after gunshot injuries. Injury. 2014;45(1):206-11. [https://doi.org/10.1016/j.injury.2012.09.021]. [PMID:23084488]

Walker RV, Frame JW. Civilian maxillo-facial gunshot injuries. Int J Oral Surg. 1984;13(4):263-77. [https://doi.org/10.1016/S0300-9785(84)80033-2]. [PMID:6434445]

Cunningham LL, Haug RH, Ford J. Firearm injuries to the maxillofacial region: an overview of current thoughts regarding demographics, pathophysiology, and management. J Oral Maxillofac Surg. 2003;61(8):932-42. [https://doi.org/10.1016/S0278-2391(03)00293-3]. [PMID:12905447]

Hollier L, Grantcharova EP, Kattash M. Facial gunshot wounds: a 4-year experience. J Oral Maxillofac Surg. 2001;59(3):277-82. [https://doi.org/10.1053/joms.2001.20989]. [PMID:11243609]

Powers DB, Delo RI. Characteristics of ballistic and blast injuries. Atlas Oral Maxillofac Surg Clin North Am. 2013;21(1):15-24. [https://doi.org/10.1016/j.cxom.2012.12.001]. [PMID:23498328]

Bak M, Jacobson AS, Buchbinder D, Urken ML. Contemporary reconstruction of the mandible. Oral Oncol. 2010;46(2):71-6. [https://doi.org/10.1016/j.oraloncology.2009.11.006]. [PMID:20036611]

Goh BT, Lee S, Tideman H, Stoelinga PJ. Mandibular reconstruction in adults: a review. Int J Oral Maxillofac Surg. 2008;37(7):597-605. [https://doi.org/10.1016/j.ijom.2008.03.002]. [PMID:18450424]

Kademani D, Keller E. Iliac crest grafting for mandibular reconstruction. Atlas Oral Maxillofac Surg Clin North Am. 2006;14(2):161-70. [https://doi.org/10.1016/j.cxom.2006.05.005]. [PMID:16959603]

Coletti DP, Caccamese JF. Diagnosis and management of mandible fractures. In: Fonseca RJ, editor. Oral and maxillofacial surgery. Philadelphia: W.B. Saunders Company; 2004. chapter 10; p. 139-61.

Primo BT, Presotto AC, de Oliveira HW, et al. Accuracy assessment of prototypes produced using multi-slice and cone-beam computed tomography. Int J Oral Maxillofac Surg. 2012;41(10):1291-5. [https://doi.org/10.1016/j.ijom.2012.04.013]. [PMID:22578568]


 


Publication date:
01/12/2016

569538f664cc8b1a57053d7b autopsy Articles

Autops Case Rep

Share this page
Page Sections