高次脳機能障害患者の下顎骨骨折術後に発生したプレート破損の1例

抄録

Higher brain dysfunction manifests as a wide variety of symptoms, and it is difficult to accurately detect the symptoms in such patients.
We performed open reduction and fixation of a mandibular fracture in a patient who had higher brain dysfunction due to a traumatic brain injury. A titanium mini-plate for fracture fixation after surgery and rigid secondary surgery became necessary.
The patient was a 4X-year-old man who was referred to our department for a right mandibular angle fracture due to a fall. On the third day after the injury, the patient underwent arch bar placement and open reduction and fixation using a mini-plate. Postoperatively, he tried to remove the arch bar and yelled repeatedly. The wound healed through an uneventful postoperative course, and he was discharged on postoperative day 7. He revisited our department for fever and swelling in the wound area on postoperative day 23. As breakage of the mini-plate was noted, we performed open reduction and fixation with 2 plates after the inflammation had resolved. Postoperative agitation was not noted. As of 1 year after surgery, no refractures had occurred, and the postoperative course was uneventful.