Fraktur comminuted bilateral pada mandibula

https://doi.org/10.22146/mkgk.31984

Ronal Ronal(1*), Abel Tasman(2), Fathurachman Fathurachman(3)

(1) Program Pendidikan Dokter Gigi Spesialis Bedah Mulut dan Maksilofasial, Fakultas Kedokteran Gigi, Universitas Padjadjaran, RSUP Dr. Hasan Sadikin, Bandung, Jawa Barat, Indonesia
(2) Departemen Bedah Mulut dan Maksilofasial, Fakultas Kedokteran Gigi, Universitas Padjadjaran, RSUP Dr. Hasan Sadikin, Bandung, Jawa Barat, Indonesia
(3) Departemen Bedah Orthopedi, Fakultas Kedokteran, Universitas Padjadjaran, RSUP Dr. Hasan Sadikin, Bandung, Jawa Barat, Indonesia
(*) Corresponding Author

Abstract


Fraktur comminuted mandibula didefinisikan sebagai adanya lebih dari satu garis fraktur yang menyebabkan terdapatnya
beberapa fragmen tulang pada satu daerah tulang mandibula (simfisis, parasimfisis, ramus, angulus). Seringkali disebabkan oleh trauma energi tinggi sehingga menyebabkan displacement yang besar, kehilangan gigi, dan luka pada jaringan lunak. Tujuan laporan kasus ini adalah untuk menjelaskan penatalaksanaan fraktur comminuted mandibula dengan menggunakan wire, plat dan screw. Hasil yang ingin dicapai pada pasien ini adalah untuk mengembalikan relasi rahang atas dan rahang bawah pasien (oklusi) yang mengalami pergeseran akibat trauma. Pasien laki laki usia 31 tahun mengalami trauma dengan mekanisme rahang membentur trotoar jalan. Pada pemeriksaan panoramik didapatkan gambaran beberapa garis fraktur pada kedua sisi rahang bawah. Sebagai penanganan awal dilakukan pemasangan kawat intermaksilaris dan dilanjutkan pemasangan wire, plat dan screw. Kesimpulan dari kasus ini yaitu rekonstruksi kembali fraktur comminuted bilateral pada mandibula sulit dilakukan karena terdapat banyak fragmen tulang yang kecil, oleh sebab itu diperlukan pemasangan wire pada daerah fraktur sebelum pemasangan plat dan screw.

ABSTRACT: Bilateral mandible comminuted fracture. Mandible comminuted fracture is define as a fracture in which there are more than one fracture line that cause a number of bone fragments on a region of mandible (symphysis, parasymphysis, body and angle). It is often caused by high energy trauma so that caused a big displacement, teeth avulsion and soft tissue injury. The purpose of this case report is to describe the treatment of bilateral mandible comminuted fracture with wire, plate and screw. The aim for this patient was to restore the occlusion between the maxilla and mandible as it was mal-aligned due to trauma. We reported a case of 31 years old man with trauma where the mechanism was his jaw hit the sidewalk. Panoramic xray showed some fracture line on both side of his mandible. We did intermaxillary wiring as first treatmentt followed by plate and screw mounting. The conclusion of this case was reconstructing a comminuted bilateral fracture on the mandible is very complicated to be done because of the small fragment of bones therefore fixation of wire at the fractured area need to be done before the fixation of plate and screw.


Keywords


bilateral, comminuted, fraktur, mandibula, trauma, bilateral, comminuted, fracture, mandible, trauma

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References

1. Bruno RC. Open versus closed reduction: comminuted mandibular fractures. Oral Maxillofac Surg. 2013. 95 – 104.

2. Vane S, Thenmozhi MS. Mandibular Fracture; An Analysis of vulnerable fracture point, types and management methods. J.Pharm.Sci &Res. 2015; 7(9): 714 – 717.

3. Marcelo ER, Vinicius NR, Danilo I. Treatment of comminuted mandibular fractures:a critical review. Med Oral Patol. 2009. 14(1): 247 – 251.

4. Abdul TL. Closed reduction for comminuted mandibular fractures. J Bagh College Dentistry. 229. 21(1): 91 – 97.



DOI: https://doi.org/10.22146/mkgk.31984

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