21462 Open treatment of mandibular fracture; with interdental fixation

Name of the Procedure:

Open Treatment of Mandibular Fracture with Interdental Fixation

• Common names: Jaw surgery, broken jaw repair
• Medical terms: ORIF (Open Reduction and Internal Fixation) of the mandibular fracture

Summary

This surgical procedure involves the realignment and stabilization of a broken jawbone using small screws, plates, and wires. Interdental fixation is employed to secure the teeth in alignment during healing.

Purpose

• Addresses broken or fractured jawbones (mandible).
• Aims to restore normal jaw function and alignment.

• Ensures proper healing of the bone.

  Indications

• Visible deformity or misalignment of the jaw.
• Difficulty chewing, speaking, or breathing.
• Pain or swelling in the jaw area.
• Trauma or injury to the jaw.
• Persistent jaw instability.
• X-ray or CT confirmation of a mandibular fracture.

Preparation

• Fasting typically required for 8 hours before the procedure.
• Adjustments to current medications as advised by the healthcare provider.
• Preoperative imaging studies (e.g., X-ray, CT scan) to assess the extent of the fracture.
• Health assessment to ensure readiness for anesthesia.

Procedure Description

1. Anesthesia: Administered general anesthesia to ensure the patient is asleep and pain-free.
2. Incision: A surgical incision is made either inside the mouth or under the jaw to access the fracture site.
3. Reduction: Fractured bone segments are realigned anatomically.
4. Fixation: Metal screws, plates, or wires are attached to stabilize and hold bone fragments in place.
5. Interdental Fixation: Dental wiring or bands are used to align and immobilize teeth, helping maintain jaw alignment.
6. Closure: Incisions are closed using sutures.

Tools and Equipment:

• Surgical drill
• Titanium plates and screws
• Dental wires/bands

Duration

• Typically takes 1.5 to 3 hours, depending on the complexity of the fracture.

Setting

• Performed in a surgical suite within a hospital or specialized surgical center.

Personnel

• Oral and maxillofacial surgeon.
• Anesthesiologist.
• Surgical nurses and dental assistants.

Risks and Complications

• Infection.
• Nerve damage resulting in numbness or tingling.
• Malocclusion or misalignment of the teeth.
• Chronic pain or discomfort.
• Issues with dental hardware (e.g., hardware failure).

Benefits

• Restored jaw function for eating, speaking, and breathing.
• Proper bone healing and stable jaw alignment.
• Reduced pain and discomfort post-recovery.

Recovery

• Pain management with prescribed medications.
• Soft or liquid diet initially; gradual reintroduction of solid foods.
• Regular oral hygiene to prevent infection.
• Follow-up appointments for monitoring healing progress.
• Physical activity restrictions typically for several weeks.
• Potential removal of dental hardware after healing, if applicable.

Alternatives

• Non-surgical treatment: Conservative management with closed reduction and immobilization (e.g., external braces).
  • Pros: Less invasive, less risk of infection.
  • Cons: Less stability, longer healing time.
• Delay in surgery: Sometimes conservative management is attempted first.
  • Pros: Avoids immediate surgical risks.
  • Cons: Increased risk if the bone heals improperly.

Patient Experience

• During procedure: The patient will be under general anesthesia and should not feel any pain.
• Post-procedure: Expect some swelling and discomfort, manageable with pain relief medications.
• Initial diet restrictions to liquid or soft foods.
• Follow-up visits to ensure proper healing and remove any temporary fixation devices.

Pain management and patient comfort are priorities, with techniques such as prescribed analgesics and cold therapy used to minimize discomfort.