Treatment of Edentulous Mandibular Fractures with Rigid Internal Fixation: Case Series and Literature Review.
Publication by:
Edgardo Franciosi, MD1 Eduardo Mazzaro, MD1 Juan Larranaga, MD1 Alfredo Rios, MD1 Pedro Picco, MD1 Marcelo Figari, MD1
1 Division of Head and Neck, Department of General Surgery, Hospital Italiano de Buenos Aires, Argentina
Craniomaxillofac Trauma Reconstruction 2014;7:35–42
Abstract The aim of the study is to analyze the effectiveness of rigid internal fixation (RIF) for
treating edentulous mandibular fractures. Because of the low incidence of fractures
in edentulous mandible, there is no consensus of the optimal treatment for it. This
study included all edentulous patients with mandibular fracture diagnosis, who were
treated with internal fixation at the Hospital Italiano de Buenos Aires from November
1991 to July 2011. Data such as age, gender, etiology and location of fracture,
surgical approach, type of osteosynthesis used, and postoperative complications
were analyzed. A total of 18 patients, 76.2 years mean age, 12 females (66.6%),
presented a total of 35 mandibular fractures. The mandibular body was the most
common localization of the fractures. Twenty-five fractures received surgical
treatment with RIF, mainly approached extraorally. Reconstruction plates were
the most common type of fixation used. Fracture reduction was considered
satisfactory in 96.5%, with 22.2% of complications and 11.1% of reoperations
needed. Open reduction and RIF demonstrated to be a reliable method for treating
edentulous mandibular fractures. Nevertheless, there is lack of high-level recommendation
publication to support this.
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Free Flap Reconstruction for Complex Scalp and Forehead Defects with Associated Full-Thickness Calvarial Bone Resections
Juan Larrañaga, MD1 Alfredo Rios, MD1 Edgardo Franciosi, MD1 Eduardo Mazzaro, MD1
Marcelo Figari, MD1
Department of Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Capital Federal, Argentina
Craniomaxillofac Trauma Reconstruction 2012;5:205–212
Abstract Extensive defects of the scalp and forehead associated with calvarial bone resections
demand complex reconstructions. Free flaps offer vascularized tissue of excellent
quality and quantity. We report six patients with extensive scalp and forehead defects
associated with calvarial bone resections reconstructed with free flaps. Five patients also
required a cranioplasty. The flaps used were two anterolateral thigh flaps, one vastus
lateralis flap, one myocutaneous latissimus dorsi flap, one latissimus dorsi flap, and one
radial forearm flap. All flaps survived with no partial necrosis. There were no donor site
complications. One patient presented an exposure of the alloplastic material used for
cranioplasty. We strongly recommend the use of free flaps for this kind of
reconstruction.
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