TREATMENT OF COMMINUTED MANDIBULAR FRACTURE WITH CLOSED REDUCTION AND MANDIBULAR FIXATION VERSUS OPEN REDUCTION AND INTERNAL FIXATION

Background and aims: Injuries from firearms remain a serious public health concern, contributing significantly to our society's morbidity, mortality, and costs. Securing an airway, controlling bleeding, determining other injuries, and conclusively repairing the traumatic facial abnormalities are the four primary phases in the care of patients with gunshot wounds to the face. This study aimed to compare the effects of two treatment approaches for mandibular gunshot injuries: closed reduction and maxillomandibular fixation (MMF) against open reduction and internal fixation. Methods: Between 2020 and 2023, mandibular fractures were found in two equal groups at the Military Hospital in Sana'a, Yemen, where the Department of Oral and Maxillofacial Surgery conducted the study. Twenty patients in group A received treatment by closed reduction and maxillo-mandibular fixation, and another twenty patients in group B received treatment by open reduction and internal fixation. Then complications following surgery were studied. Every patient had made a follow-up call between the second and eighth weeks; following the surgery, both groups' cases of postoperative infection, malocclusion, non-union or malunion of fracture fragments, facial asymmetry, exposed plates, and bone resorption were recorded and assessed radiographically and clinically. Results: The study analyzed patients with mandible fractures, focusing on G.S.I. and bomb explosions. Most injuries occurred in the body, with parasymphsis being the most common site. Bone exposure was prevalent in 95% of patients. After a two-week follow-up, the ORIF treatment method was associated with more post-operative complications than the CR-MMF treatment method. Wound contraction was more common in the ORIF group (22.5%), followed by bone loss (15%). Plate exposure, nonunion, and malunion were more prevalent in the ORIF group. Conclusions: In comparison to open reduction with internal fixation, it was determined that closed reduction is the most efficient and dependable management strategy for treating comminuted fractures of the mandible brought on by gunshot injuries. It also has a lower rate of complications. Peer Review History: Received 18 July 2024; Reviewed 13 September 2024; Accepted 20 October; Available online 15 November 2024 Academic Editor: Dr. A.A. Mgbahurike, University of Port Harcourt, Nigeria, [email protected] Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Dr. Adebayo Gege Grace Iyabo, University of Ibadan, Nigeria, [email protected] Dr. Ahmed Mohammed Al-Haddad, Hadhramout University, Al-Mukalla, Yemen, [email protected]