Delayed union of mandible: analysis of general and local factors.

Authors

DOI:

https://doi.org/10.26641/2307-0404.2019.1.162299

Keywords:

mandibular fracture, delayed union, risk factors, prognosis

Abstract

Objective to evaluate the etiological significance of local and general factors in the occurrence of delayed union of bone tissue in patients with mandibular fractures. a personalized questionnaire was developed and filled by 74 patients with fragments mobility that persisted 1 month after reposition and fixation of the mandibular fractures for determination the role of local and general factors in the occurrence of delayed union. Thus, local and general factors that most closely correlate with the development of this complication were identified. The obtained data were compared with the results of a retrospective analysis of case histories of patients with mandibular fractures over a five-year period. The presence of a general somatic pathology, head injury and polytrauma, as well as such aggravating factors as alcohol and drug abuse should be considered as the general risk factors for the development of the delayed union of mandibular fractures. Among local factors, inflammation in the area of  mandibular fractures takes the first place, the development of which is provoked by untimely treatment of patients, comminuted fractures, traumatic surgical interventions, etc. Among patients with delayed union of mandibular fractures, 86.5% received antibiotics for more than ten days. The risk group should also include patients with mandibular fractures of a young age (from 18 to 25 years) and those over 45 years. The problem areas for consolidation are mental section (31.1%) and the angle of the jaw (25.7%).

Author Biography

N. N. Idashkina

SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine»
V. Vernadsky str., 9, Dnipro, 49044, Ukraine

References

Bahteeva GR. [Features of the course and treat­ment of mandibular fractures, accompanied by damage to the third branch of the trigeminal nerve]. [dissertation]. GOU VPO «VGMU Roszdrava». 2010;24. Russian.

Vares YaE, Got IM, Filipska TA. [Features of osteo­synthesis of mandible in conditions of compromised quality and quantity of bone tissue]. Novyny stomatologii. 2009;4:18-23. Ukrainian.

Gulyuk AG, Taschyan AE,Gulyuk LN.[The prevention of the complication of consolidation at the fractures of lower jaw in patients with structural and metabolic changes in osseous tissue]. Visnyk stomato­logii. 2012;2:65-71. Russian.

Dorohin AI. [Comprehensive treatment of bone fractures complicated by consolidation disorders in chil­dren (clinical and experimental study)]. [dissertation]. GOUVPO "Rossiyskiy gosudarstvennyiy meditsinskiy universitet". Moskva. 2005;227. Russian.

Klimovitskiy VG, Chernyish VYu. [Frequency of delayed consolidation of fractures in victims of different age groups and the effect of osteotropic therapy on it]. Travma. 2011;12(3):1-7. Russian.

Kopchak AV. [The physicians’ mistakes and com­plications in surgical treatment of traumatic fractures of mandible]. Klinichna hirurgiia. 2013;1:30-3. Ukrainian.

Lazebnik LB, Nazarenko IV, Nasonov EL. et al. [Epidemiology, prevention, variants of clinical course, treatment of osteoporosis and its complications. Methodical manual for doctors]. Komitet zdravoohra­neniya Pravitelstva Moskvy. 2003;68. Russian.

Nagirniy YaP. [Ways of optimization of repara­tive osteogenesis in patients with traumatic mandibular fractures]. [dissertation]. TDMU. 2008;298. Ukrainian.

Petrov MA. [Prediction and treatment of disorders of reparative osteogenesis in children]. [dissertation]. GOUVPO "Rossiyskiy gosudarstvennyiy meditsinskiy uni­versitet", Moskva. 2006;34. Russian.

Nemsadze VP, Vyibornov DYu,Tarasov NI, Bazhanova NN. [Systems for evaluating the results of treatment of children with trans – and epicondyle fractu­res of the humerus with displacement]. Voprosyi sovre­mennoy pediatrii. 2006;5(1):412. Russian.

Ryzhikova TA. [Improvement of mandibular frac­tures treatment with the preservation of intact teeth in the injury zone]. [dissertation]. GOU VPO «PGMA MZ RF». 2005;139.

Timofeev AA, Fesenko EI. [Condition of the teeth in the mandible fracture gap]. Sovremennaya stoma­tologiya. 2016;4:73-82. Russian.

Li Z, Zhang W, Li ZB, Li JR. Abnormal union of mandibular fractures: a review of 84 cases. J Oral Maxillofac Surg. 2006;64(8):1225-31. doi: https://doi.org/10.1016/j.joms.2006.04.018

Adell R, Eriksson B, Nylén O, Ridell A. Delayed healing of fractures of the mandibular body. J Maxillofac Oral Surg. 1987;16(1):15-24. doi: https://doi.org/10.1016/S0901-5027(87)80026-7

Guerrissi JO. Fractures of mandible: is sponta­neous healing possible? Why? When? J. Craniofac. Surg. 2001;12(2):157-66. doi: https://doi.org/10.1097/00001665-200103000-00013

Haug RH. Fibrous union of the mandible: A review of 27 patients. RH Haug, A Schwimmer. J Oral Maxillofac Surg.1994;52:832-9. doi: https://doi.org/10.1016/0278-2391(94)90230-5

Idashkina N. Five Years Retrospective Study of Mandibular Fractures in Mechnikov Regional Clinical Hospital, Dnipropetrovsk. Europ J Biomedical Life Sciences. 2018;3:3-6.

Snäll J, Apajalahti S, Suominen AL, Törnwall J, Thorén H. Influence of perioperative dexamethasone on delayed union in mandibular fractures: a clinical and radiological study. Med Oral Patol Oral Cir Bucal. 2015;20: 621-6. doi: https://doi.org/10.4317/medoral.20553

Mathog RH, Toma V, Clayman L, Wolf S. Nonu­nion of mandible: an analysis of contributing factors. J Oral Maxillofac Surg. 2000.58(7):746-53. doi: https://doi.org/10.1053/joms.2000.7258

Seiji Nakamura, Yashura Takanoshita, Masuichi­ro. Complications of miniplate osteosynthesis for Mandibular fracture. J. Oral Maxillofacial Surge­ry.1994;52:233-8. doi: https://doi.org/10.1016/0278-2391(94)90289-5

Published

2019-04-02

How to Cite

1.
Idashkina NN. Delayed union of mandible: analysis of general and local factors. Med. perspekt. [Internet]. 2019Apr.2 [cited 2024Nov.22];24(1):50-61. Available from: https://journals.uran.ua/index.php/2307-0404/article/view/162299

Issue

Section

CLINICAL MEDICINE