21461 Open treatment of mandibular fracture; without interdental fixation

Name of the Procedure:

Open Treatment of Mandibular Fracture; Without Interdental Fixation

Summary

This surgical procedure involves the open treatment of a broken lower jaw (mandibular fracture) without using wires or appliances to join teeth together (interdental fixation).

Purpose

The procedure addresses a broken jaw and aims to realign and stabilize the fractured bone. The expected outcome is proper healing of the jaw, restoration of normal function, and alleviation of discomfort.

Indications

• Visible misalignment or deformity of the jaw.
• Difficulty chewing or speaking due to jaw pain.
• Swelling, bruising, or bleeding in the jaw area.
• Patients who cannot undergo interdental fixation due to other dental complications or preferences.

Preparation

• Fasting for at least 8 hours prior to the procedure.
• Adjusting medications as advised by the healthcare provider.
• Preoperative imaging, such as X-rays or CT scans, to assess the fracture.

Procedure Description

1. The patient is placed under general anesthesia.
2. An incision is made either inside the mouth or on the skin near the jaw.
3. The fractured bone segments are exposed and realigned.
4. Plates and screws are used to stabilize the bone.
5. The incision is closed with sutures.
6. No interdental wires or plates are used to fixate the teeth together.

Duration

The procedure typically lasts 1 to 3 hours, depending on the complexity of the fracture.

Setting

The procedure is performed in a hospital operating room or a specialized surgical center.

Personnel

• Oral and Maxillofacial Surgeon
• Anesthesiologist
• Surgical Nurses
• Operating Room Technicians

Risks and Complications

• Infection at the surgical site.
• Bleeding or hematoma.
• Nerve injury leading to numbness or altered sensation.
• Malunion or improper healing of the bone.
• Need for additional surgery.

Benefits

• Proper healing and stabilization of the jaw.
• Relief of pain and discomfort.
• Restoration of normal jaw function and aesthetics.
• Immediate functional improvement post-surgery, compared to methods requiring interdental fixation.

Recovery

• Pain management with prescribed medications.
• Soft or liquid diet for several weeks.
• Avoidance of strenuous activities for a specified period.
• Follow-up appointments for monitoring healing and removal of sutures/staples.

Alternatives

• Closed reduction with mandibulomaxillary fixation (interdental fixation).
• Conservative management with pain control and a soft diet (for minor fractures).
• Each alternative has its own pros and cons, with closed reduction requiring the patient to manage with jaw wires for many weeks.

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel any pain. Post-procedure, the patient may experience swelling, bruising, and pain managed by medication. Comfort measures include ice packs and a soft diet.