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March 1982

Treatment of Fractures of the Edentulous Mandible

Author Affiliations

From the Division of Otolaryngology-Head and Neck Surgery, Stanford (Calif) University Medical Center (Drs Levine and Goode); and the Division of Otolaryngology-Head and Neck Surgery, Santa Clara Medical Center, San Jose, Calif (Dr Levine).

Arch Otolaryngol. 1982;108(3):167-173. doi:10.1001/archotol.1982.00790510039008

• The reduction and fixation techniques for treatment of fractures of the edentulous mandible are varied, although all the operative techniques are based on the fundamental principles of adequate bone fragment apposition and immobilization. The techniques include the following: (1) analgesia and soft diet, (2) closed reduction with splint fixation, (3) open reduction (intraoral or extraoral) with transosseous wire ligation, (4) percutaneous intramedullary pinning, (5) intraoral open reduction with bone graft and maxillomandibular fixation, (6) external splint fixation appliance, (7) extraoral open reduction and fixation with malleable mesh, and (8) extraoral open reduction and fixation with bone plating (metacarpal, lateral compression, and eccentric dynamic compression plate [EDCP]). We review the various modalities of therapy for this challenging problem, with the strengths and weaknesses of each technique. In addition, we discuss a relatively new method of fracture fixation in North America, the EDCP, and our experience using it to treat 17 fractures of the edentulous or nearly edentulous mandible, with a 94% bony healing rate.

(Arch Otolaryngol 1982;108:167-173)