Ballistic maxillofacial trauma represents a challenge for surgeons because of the important comminution process it presents. Specifically, in cases of mandibular comminuted fractures, the different treatment modalities include closed reduction, external fixation and internal fixation. The purpose of this case series is to describe an initial treatment modality, with a fixation method for comminuted mandibular fractures as an alternative for the classic external fixator. We conducted a literature review about the initial treatment for ballistic comminuted mandibular fractures, emphasizing indications of each treatment modality and their respective advantages and disadvantages. Next, we described the preparation process of an alternative fixation method along with a case series, where it was used as a therapeutical alternative. The reduction as well the fixation achieved by the external fixator, showed satisfactory results without significant differences noted with traditional fixation methods. Both, reconstruction plates and external fixators, are valid alternatives for treating comminuted mandibular fractures. The method described and used in these patients is and efficient alternative, easy to make and at a low cost, with good results in relation to fracture consolidation. We propose that every treatment modality and its indications should be evaluated in order to treat each case adequately.
KEY WORDS: mandibular fracture, comminution, ballistic projectile, reconstruction plate, external fixator.
How to cite this article
MARDONES, M. M.; BRAVO, A. R.; ALTSCHILLER, M. J.. & PÉREZ, G. H. Mandibular fractures comminuted by ballistic projectile impact: Initial treatment proposal using alternative fixation method. Int. J. Odontostomat., 12(4):423-430, 2018.