Oral and Maxillofacial Surgery

Case of the Month


October 1997


Subjective:

The patient was referred to our practice by the Neurosurgery service for treatment of a mandibular symphysis fracture. Patient had a loss of consciousness following a bar room fight.

Objective:

Medical history revealed a 30 y.o. white single male with no known drug allergies, no medications, previous operations, or serious illnesses. Family history was noncontributory. Social history was positive for cigarette smoking and daily beer consumption.

Laboratory data was within normal limits.
Oral examination revealed missing teeth # 1, 2, 14, 18, and 32. A traumatic malocclusion was noted. Hemorrhage and laceration of the gingiva was noted in area # 25 and # 26. Gingival recession was present on the labial surface of # 25. Bimanual manipulation of the mandibule revealed a symphysis fracture between teeth # 25 and # 26. The mandibular condyles, angles, and body were intact. Severe displacement of the fracture occurred when the patient tried to obtain centric occlusion. Sublingual ecchymosis was present.

Assessment:

  1. Closed Head Injury
  2. Mandibular Symphysis Fracture
  3. ETOH abuse
  4. Gingival Recession

Plan:

  1. Admission to Owensboro Mercy Health System
  2. Neurosurgery Evaluation
  3. General Anesthesia
  4. Application of Maxillary and Mandibular Arch Bars
  5. Open Reduction Internal Fixation of Mandibular Symphysis Fracture via Lag Screw Technique

Results:

Intraoperative digital photograph of mandibular symphysis fracture showing fracture diastema.
Intraoperative digital photograph of reduced mandibular symphysis fracture via lag screw technique. Note right mental nerve.
Postoperative radiograph of reduced mandibular symphysis fracture via lag screw technique.

Patient treated by:
  • Dr. Steven R. Tucker Oral and Maxillofacial Surgery


 Steven R. Tucker DMD, PSC
 Oral and Maxillofacial Surgery
 909 Scherm Road
 Owensboro, KY 42301
 phone: 1-502-926-4107
 fax: 1-502-926-4166
 url: http://www.srt-psc.com

steven@occ-uky.campus.mci.net

Last Modified: September 30, 1997

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