Marwa A Attyia
Al-Yarmouk Teaching Hospital, Iraq
Mudher M B Alsunbuli
Al-Bayan University, College of dentistry, Iraq
Imad S Noorali
Al-Yarmouk Teaching Hospital, Iraq
ABSTRACT
Background: Open reduction and internal fixation (ORIF) of mandibular fractures under local anesthesia presents challenges, primarily in achieving adequate pain control while keeping the patient awake and responsive. This approach may be necessary for patients with contraindications to general anesthesia or those who prefer to remain conscious during the procedure. Although traditionally considered more complex than ORIF under general anesthesia, local anesthesia offers potential advantages in selected cases. Objective: This study aimed to evaluate the feasibility and effectiveness of performing ORIF for mandibular fractures under local anesthesia using intraoral and extraoral surgical approaches. Additionally, it assessed postoperative stability, functional recovery, and associated complications. Methodology: A prospective clinical study was conducted at the Department of Oral and Maxillofacial Surgery, Al-Yarmouk Teaching Hospital, Baghdad, Iraq, from January to November 2022. The study included 19 patients with isolated mandibular fractures who met the inclusion criteria. Patients were treated with ORIF under local anesthesia, and outcomes were assessed based on surgical approach, postoperative stability, functional restoration, and complication rates. Conclusion: When planning treatment, factors such as the cause of injury, fracture type, and anatomical location should be carefully considered. The study found no statistically significant differences in preoperative parameters between intraoral and extraoral approaches for mandibular fracture treatment. ORIF under local anesthesia was found to be a feasible and effective technique for managing mandibular fractures. However, larger-scale studies are necessary to validate these findings. While the surgical approach may influence certain preoperative parameters and fracture types, it does not appear to significantly impact postoperative outcomes such as malocclusion, maximal mouth opening, or the duration of arch bar placement. An individualized approach to mandibular fracture management remains essential to achieving optimal patient outcomes.
Keywords: Fracture Mandible; Open Reduction; Internal Fixation; Local Anesthesia.
