Gunshot injury to the mandible of a patient due to domestic violence with tough treatment process: A case report

Abstract

Gunshot wounds (GSWs) are a significant cause of trauma in the maxillofacial region, particularly in the mandible. Following the establishment of a treatment plan, patients may experience various complications, which often necessitate a secondary surgical intervention to correct the patient's concerns. This case study presents the details of a 36-year-old female patient who experienced a gunshot injury six years ago, that resulted in a fracture of the mandibular ramus. As a consequence of the injury, the mandibular condyle and coronoid process migrated into the infraorbital fossa, causing difficulty with mastication and mouth opening. To correct this issue, a surgical procedure was performed that included submandibular and preauricular incisions. The condyle was replaced and fixed with rigid internal fixation and maxillomandibular fixation techniques. Additionally, an abdominal fat graft was harvested and transplanted into the mandible. Postoperative follow-up was conducted, but after two weeks, the patient developed an infection, necessitating a transfer to the infection department. Fortunately, after one month, the infection was successfully treated, and the patient was discharged in good health. In the follow-up period, the patient has acceptable function and well-being in the other health condition.

Keywords

• Gunshot
• wound
• trauma
• mandible
• infection

Aile içi şiddet sebebiyle bir hastanın mandibulasına oluşan ateşli silah yaralanmasının zorlu tedavi süreci: Bir olgu raporu

Abstract

Ateşli silah yaralanmaları (GSY), özellikle mandibula bölgesinde, maksillofasiyal bölgede önemli bir travma nedenidir. Tedavi planının belirlenmesini takiben, hastalarda genellikle çeşitli komplikasyonlar gelişebilir ve bu durum hastanın şikayetlerini gidermek amacıyla ikincil cerrahi müdahaleleri gerekli kılar. Bu olgu sunumunda, altı yıl önce ateşli silah yaralanması geçirmiş 36 yaşındaki bir kadın hastanın durumu ele alınmaktadır. Yaralanma sonucunda mandibular ramusta bir kırık oluşmuş ve mandibular kondil ile koronoid çıkıntı infraorbital fossaya göç etmiştir. Bu durum hastada çiğneme ve ağız açmada zorluklara neden olmuştur. Bu sorunu düzeltmek amacıyla submandibular ve preauriküler insizyonları içeren bir cerrahi işlem gerçekleştirilmiştir. Kondil, yerine yerleştirilmiş ve rijid internal fiksasyon ile maksillomandibular fiksasyon teknikleri kullanılarak sabitlenmiştir. Ayrıca, karın bölgesinden yağ grefti alınarak mandibula bölgesine transplant edilmiştir. Ameliyat sonrası takip süreci yürütülmüş; ancak iki hafta sonra hastada enfeksiyon gelişmiş ve enfeksiyon servisinde tedavi görmesi gerekmiştir. Neyse ki, enfeksiyon bir ay içerisinde başarıyla tedavi edilmiş ve hasta sağlıklı bir şekilde taburcu edilmiştir. Takip sürecinde, hastanın genel sağlık durumu iyi olup fonksiyon açısından kabul edilebilir düzeyde iyileşme gözlemlenmiştir.

Keywords

• Ateşli silah
• yara
• travma
• mandibular
• enfeksiyon
• yağ grefti

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