Thursday, November 24, 2011

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Open reduction and internal fixation or open treatment of bilateral mandibular fractures (OP Report Sample)


PREOPERATIVE DIAGNOSES: Left mandibular angle fracture.  Right parasymphyseal fracture.

POSTOPERATIVE DIAGNOSES: Left mandibular angle fracture.  Right parasymphyseal fracture.

OPERATION PERFORMED: Open reduction and internal fixation or open treatment of bilateral mandibular fractures including left angle and right parasymphyseal using multiple techniques, internal hardware fixation, and placement interdental fixation.

OPERATION: The patient brought to the operating room, draped, and prepped in routine manner.  The appropriate consents and time-outs were performed.  General anesthesia was performed by the Department of Anesthesia using a nasotracheal intubation.  At the beginning of the operation, the patient placement of IMF screws and the placement of the intermaxillary arch bars.  IMF screws placed on the maxilla and a lower arch bar was placed initially just the left half of the arch bar was fixated.  After this was performed, patient underwent exposure of the fractures through a right buccogingival incision anteriorly.  Care was taken to preserve the mental nerve and for the patient undergo a left exposure of the left ankle fracture through an incision of the oblique ridge.  After that was obtained, patient's right anterior parasymphyseal fractures was placed into reduction using reduction forceps.  Patient underwent placement of 2 mono-cortical plates each using 6 and 5 mm screws.  Because of lack of exact reduction, the patient's reduction was then adjusted after loosening the screws, repositioning the dental plate and then tightening the screws again.  The left submandibular angle fracture was managed through the placement of an oblique ridge of plate being placed with 6-mm mono-cortical screws along the lines of osteosynthesis.  After this, the remainder the patient's arch bars was placed into a dental fixation, the occlusion was again readjusted and then the patient was placed in rubber band bench.  At the end of the procedure, the patient's wounds were closed using 4-0 Vicryl and 3-0 chromic.  The patient tolerated procedure well.  There were no complications.

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