Evaluation of patients submitted to conservative treatment of jaw fracture in fire weapon projectile

264 The financial case for using orthodontic brackets as a method of intermaxillary fixation in suitable mandible fractures S. Ria ∗ , R. Attwall, A. Bakir, B. Ria, M. Perry, I. Balasundaram Northwick Park Hospital, London, United Kingdom Background: Although open reduction and internal fixation is a common method for treating mandibular fractures, certain cases are still suitable for intermaxillary fixation (IMF) alone. Arch bars, Leonard buttons and IMF screws are commonly used methods at this regional trauma centre in London. However, these methods of IMF usually require admission of a patient and a general anaesthetic (GA). Orthodontic brackets with elastics are a simpler method of IMF, which can be placed in the emergency department without the need for admission, and GA. Objectives: The purpose of this study was to identify all mandibular fractures requiring IMF placement under GA that may have been suitable for treatment using orthodontic brackets and elastics instead. Using this data we then performed a cost analysis to see how much money the hospital could have saved. Methods: All mandibular fractures treated solely with IMF in the past 12 months were identified. The length of admission, time to theatre and time in theatre was identified. Costing for this was performed and the amount that potentially could have been saved were calculated. Findings: 11 patients were identified. They spent a total of 19 days in hospital and 15.8 h in the operating theatre at a total cost of £26,600. Conclusion: In suitable cases orthodontic brackets and elastics can be used as an effective method of IMF. This can reduce the hospital admission rate and need for GA. This will not only reduce costs for the hospital but also intangible costs for the patient. http://dx.doi.org/10.1016/j.ijom.2017.02.889 Evaluation of patients submitted to conservative treatment of jaw fracture in fire weapon projectile M.I. Serpa Paiva Damasceno ∗ , N.B. de Aguiar Filho, R.L. Maia Nogueira, B.C. do Egito Vasconcelos, G.G. Pimentel Hospital Batista, Brazil Background: The treatment of gunshot injuries in the face somehow led to the development of modern maxillofacial surgery, and remains one of the main challenges of the specialty. Conservative treatment of this fracture has been cited by many scholars of the subject as the form of procedure in obtaining greater success with less morbidity for the patient. This study aims to evaluate patients who underwent conservative treatment of mandibular fracture by projectile from a firearm through maxillomandibular block. Methods: The sample consisted of six patients, where a descriptive analysis was performed with obtaining and measuring mandibular movements, obtaining computed tomography scans to assess bone morphology and a subjective evaluation with the application of the Oral Health Impact Profile-14 questionnaire to assess quality of life. Results: Patients had a maximum aperture of mouth mean 45.42 mm, 3.38 mm with an average protrusion, and right and left laterality were averaging 9.49 and 7.39, respectively. In imaging evaluation, three patients had unchanged morphological, two

patients with mild alteration and one patient with moderate alteration. Given the quality of life was observed that patients one, two and four got a great quality of life, patient five a good quality of life and patients three and six showed a moderate quality of life. Conclusion: It was observed that with the proposed treatment patients showed maintenance of mandibular movements, bone repair without major morphological changes and the patients reported a good quality of life. http://dx.doi.org/10.1016/j.ijom.2017.02.890 Impaled wooden foreign body traversing inferior orbital fissure — report of an interesting case V. Singh Pt. B.D. Sharma University of Health Sciences, Rohtak, India Penetrating orbital injuries with or without retained intraorbital foreign bodies (IOrbFBs) are uncommon but often dramatic injuries. Orbital penetration by a wooden foreign body is relatively rare, especially in impalement injuries where the head can be impaled on a stationary object. Although orbital injuries are most commonly examined by the ophthalmologist or oculoplastic department, the maxillofacial surgeon may be more adept at management of retained foreign body when the bony structures of the orbit are involved. We encountered such a case of a 7-month-old orbital impalement injury by a wooden twig from a shrub, which was successfully retrieved in a short operation. Though uncommon these injuries have been reported in ophthalmology literature, but are still a rare presentation to the maxillofacial surgeon who may actually be just as adept or more at management of these when bony structures are involved. The purpose of reporting this case is to highlight the rare nature of disease, and importance of meticulous planning in managing such cases with rare presentations and sound anatomical knowledge. Also to emphasise that these injuries may fall well within the forte of the maxillofacial surgeon. http://dx.doi.org/10.1016/j.ijom.2017.02.891 Temporomandibular joint ankylosis secondary to panfacial fracture C. Vazquez-Martinez ∗ , I. Zubillaga, F. Merino, V. Zafra, G. Sanchez-Aniceto H. U. 12 de Octubre, Madrid, Spain Panfacial fractures (PF) involve upper, middle and lower third of the face. Condylar fractures may be present. They can be intracapsular, which is more associated with ankylosis of the temporomandibular joint (TMJ), or extracapsular. TMJ ankylosis appears de novo or after primary treatment. We report a case of panfacial fracture associated with bilateral condylar fracture. We proceeded in a “top-down and outsidein” sequence to restore facial skeleton. Both condylar fractures were treated with semi-rigid fixation. While miniplate fixation was used for right condyle, wire fixation was chosen for the left one. No immediate postoperative complications arose. After 18-month follow-up, control mandible computer-assisted