Distraction osteogenesis application in bone defect caused by osteomyelitis following mandibular fracture surgery: a case report and literature review

牵引成骨术在下颌骨骨折术后骨髓炎所致骨缺损中的应用:病例报告及文献综述

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Abstract

BACKGROUND: Osteomyelitis secondary to mandibular fracture surgery is rare and complete surgical debridement of necrotic infected tissues is an optimal treatment for it. Subsequent reconstruction is required for bone defect caused by operation. Autogenous, allograft and synthetic bone graft substitutes have become widespread in bone defect treatment. Distraction osteogenesis (DO) was also applied in bone defect reconstruction, even it wasn't conventional therapy in jaw. CASE PRESENTATION: Here we report a case of a 40-year-old aged man who presented with chronic swelling and pain on the right mandibular masseteric region after mandibular angle and Le Fort II fracture surgery. In six weeks after surgery, CBCT images showed that the fracture ends hadn't heal and the fracture gap had widened significantly. The clinical diagnosis of the patient was right mandibular angle osteomyelitis. After controlling the symptoms of pain and infection with local rinses and systemic antibiotic therapy, the patient underwent segmental resection of the infected bone and DO reconstruction for bone defect simultaneously. Encouragingly, well bone healing and normal occlusion restoration was observed finally. CONCLUSIONS: DO could be a valuable alternative therapy to bone grafts for bone defect, even in the case of infection.

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