Abstract
The observations conducted by the authors showed that of 285 patients with craniofacial combined injury 107 (male-91, female-16) had mandibular (lower jaw) fractures.According to the mandibular fracture combinations with other facial bones and craniocerebral injuries, mandibular fracture combined with cerebral injuries (40%), mandibular fracture combined with craniocerebral injury is very rare (12%), simultaneous injuries of mandible and other facial bones is always concomitant with cranio-cephalic injuries of different severity (48%).For treatment of mandibular fractures, surgery was suggested as the treatment of choice by the authors - open repositioning and fixation of fractured fragments by Titanium miniplates and screws under nasotracheal general anesthesia.For approach to mandibular condylar fracture line an intraoral incision has been used. At fracture of condylar processes (especially when a small piece of fragment is dislocated out of the fossa), to provide free direct approach to the fractured fragment after surgical treatment and to prevent facial nerve traumatic damage has been applied the following approach: after isolation/detachment of skin-fat segment from the mastication muscle, muscle dissection was done not at the edge of its mandibular fixation but at the border of its upper and middle third. Having detached the upper segment of muscle from the bone the area of mandibular joint is free for direct approach and nerve branches, nerve branches are not damaged. Dislocated joint head fractured fragment was returned to the fossa and fixation to mandibular branch was performed by Titanium miniplates and screws.In the mandibular body and angle area, an intraoral incision approach to mandibular condylar fractures is considered as more cosmetic providing a firm and accurate fixation of the fragments. Surgical treatment used for mandibular condylar fractures prevents facial nerve traumatic damage, ensures proper observation of the damaged area and makes it possible to provide a firm and accurate fixation of the fragments.
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