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

Year 2025, Volume: 4 Issue: 2, 39 - 42, 29.05.2025

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.

References

  • 1. Erol B, Tanrikulu R, Görgün B. Maxillofacial fractures. Analysis of demographic distribution and treatment in 2901 patients (25- year experience). J Craniomaxillofac Surg. 2004;32(5):308-313. doi:10.1016/j.jcms.2004.04.006
  • 2. Chrcanovic BR, Abreu MH, Freire-Maia B, Souza LN. 1,454 mandibular fractures: a 3-year study in a hospital in Belo Horizonte, Brazil. J Craniomaxillofac Surg. 2012;40(2):116-123. doi:10.1016/j.jcms.2011.03.012
  • 3. Grossmann E, Silva AN Jr, Collares MV. Surgical management of a projectile within the temporomandibular joint. J Craniofac Surg. 2012;23(2):613-615. doi:10.1097/SCS.0b013e31824cd831
  • 4. Pires MS, Giongo CC, Antonello Gde M, Couto RT, Filho Rde O, Junior OL. An interesting case of gunshot injury to the temporomandibular joint. Craniomaxillofac Trauma Reconstr. 2015 Mar;8(1):79-82. doi: 10.1055/s-0034-1390244. Epub 2014 Sep 15. PMID: 25709756; PMCID: PMC4329033.
  • 5. Demetriades D, Chahwan S, Gomez H, Falabella A, Velmahos G, Yamashita D. Initial evaluation and management of gunshot wounds to the face. J Trauma. 1998;45(1):39-41. doi:10.1097/00005373-199807000-00007.
  • 6. Lauriti, Leandro et al. “Gunshot injuries in the maxillofacial region: a retrospective analysis and management.” Brazilian Journal of Oral Sciences 10 (2011): 236-240.
  • 7. Newlands SD, Samudrala S, Katzenmeyer WK. Surgical treatment of gunshot injuries to the mandible. Otolaryngol Head Neck Surg. 2003;129(3):239-244. doi:10.1016/S0194-5998(03)00481-9
  • 8. Guevara C, Pirgousis P, Steinberg B. Maxillofacial Gunshot Injuries: A Comparison of Civilian and Military Data. J Oral Maxillofac Surg. 2016;74(4):795.e1-795.e7957. doi:10.1016/j. joms.2015.11.007
  • 9. Sali Bukhari SG, Khan I, Pasha B, Ahmad W. Management of facial gunshot wounds. J Coll Physicians Surg Pak. 2010;20(6):382-385.
  • 10. Çetingül, Erdoğan. Çene ve yüz travmatolojisi. Ege Üniversitesi Diş Hekimliği Fakültesi Yayınları, 2002.
  • 11. Fonseca RJ Marciani RD Turvey TA. Oral and Maxillofacial Surgery. 2nd ed. St. Louis Mo: Saunders/Elsevier; 2009.
  • 12. Oral and Maxillofacial Anatomy, The First Affiliated Hospital School of Medicine, Zhejiang University, Prof. Dr. Gu Xinhua, https://www.slideshare.net/deepak15/part1anatomy
  • 13. Lee KH, Epidemiology of mandibular fractures in a tertiary trauma center, Emergency Medicine Journal, 2008;25:565-568
  • 14. World World Health Organization. “Devastatingly Pervasive: 1 in 3 Women Globally Experience Violence.” Www.who.int, World Health Organization, 9 Mar. 2021, www.who.int/news/item/09-03-2021-devastatingly-pervasive-1-in-3-women-globallyexperience-violence.
  • 15. Basar F, Demirci N. Domestic violence against women in Turkey. Pak J Med Sci. 2018 May-Jun;34(3):660-665. doi: 10.12669/pjms.343.15139. PMID: 30034434; PMCID: PMC6041515
  • 16. Casale J, Bordoni B. Anatomy, Head and Neck: Infratemporal Fossa. [Updated 2022 Jul 25]. In: StatPearls [Internet]. TreasureIsland (FL): StatPearls Publishing; 2023 Jan-.
  • 17. Muddassar M, Arshad R, Rabbani S, Qureshi IS, Khattak IK, Rana Z. Management of Gunshot Injuries of Mandible with Open Reduction and Internal Fixation versus Closed Reduction and Maxillo-mandibular Fixation. Cureus. 2020;12(4):e7830. Published 2020 Apr 25. doi:10.7759/cureus.7830.
  • 18. Siddiqui S-u-d et al., Efficacy of open reduction and internal fixation in achieving bony union of comminuted mandibular fractures caused by civilian gunshot injuries, The Surgeon, https://doi.org/10.1016/j.surge.2019.
  • 19. Rana M, Warraich R, Rashad A, et al. Management of comminuted but continuous mandible defects after gunshot injuries. Injury. 2014;45(1):206-211. doi:10.1016/j.injury.2012.09.021.
  • 20. Muddassar M, Arshad R, Rabbani S, Qureshi IS, Khattak IK, Rana Z. Management of Gunshot Injuries of Mandible with Open Reduction and Internal Fixation versus Closed Reduction and Maxillo-mandibular Fixation. Cureus. 2020;12(4):e7830. Published 2020 Apr 25. doi:10.7759/cureus.783.
  • 21. Fagin AP, Dierks EJ, Bell RB, Cheng AC, Patel AA, Amundson MS. Infection prevalence and patterns in self-inflicted gunshot wounds to the face. Oral Surg Oral Med Oral Pathol Oral Radiol. 2019;128(1):9-13. doi:10.1016/j.oooo.2019.02.022.
  • 22. Powers DB, Will MJ, Bourgeois SL Jr, Hatt HD. Maxillofacial trauma treatment protocol. Oral Maxillofac Surg Clin North Am. 2005;17(3):341-vii. doi:10.1016/j.coms.2005.05.003.
  • 23. Sharma, Rohit & Jose, Anson. (2021). Gunshot Injuries of the Maxillofacial Region. 10.1007/978-981-15-1346-6_59.
  • 24. Arcuri F, Brucoli M, Baragiotta N, Stellin L, Giarda M, Benech A. The role of fat grafting in the treatment of posttraumatic maxillofacial deformities. Craniomaxillofac Trauma Reconstr. 2013 Jun;6(2):121-6. doi: 10.1055/s-0033-1333877. Epub 2013 Mar 8. PMID: 24436747; PMCID: PMC3721009.

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

Year 2025, Volume: 4 Issue: 2, 39 - 42, 29.05.2025

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.

References

  • 1. Erol B, Tanrikulu R, Görgün B. Maxillofacial fractures. Analysis of demographic distribution and treatment in 2901 patients (25- year experience). J Craniomaxillofac Surg. 2004;32(5):308-313. doi:10.1016/j.jcms.2004.04.006
  • 2. Chrcanovic BR, Abreu MH, Freire-Maia B, Souza LN. 1,454 mandibular fractures: a 3-year study in a hospital in Belo Horizonte, Brazil. J Craniomaxillofac Surg. 2012;40(2):116-123. doi:10.1016/j.jcms.2011.03.012
  • 3. Grossmann E, Silva AN Jr, Collares MV. Surgical management of a projectile within the temporomandibular joint. J Craniofac Surg. 2012;23(2):613-615. doi:10.1097/SCS.0b013e31824cd831
  • 4. Pires MS, Giongo CC, Antonello Gde M, Couto RT, Filho Rde O, Junior OL. An interesting case of gunshot injury to the temporomandibular joint. Craniomaxillofac Trauma Reconstr. 2015 Mar;8(1):79-82. doi: 10.1055/s-0034-1390244. Epub 2014 Sep 15. PMID: 25709756; PMCID: PMC4329033.
  • 5. Demetriades D, Chahwan S, Gomez H, Falabella A, Velmahos G, Yamashita D. Initial evaluation and management of gunshot wounds to the face. J Trauma. 1998;45(1):39-41. doi:10.1097/00005373-199807000-00007.
  • 6. Lauriti, Leandro et al. “Gunshot injuries in the maxillofacial region: a retrospective analysis and management.” Brazilian Journal of Oral Sciences 10 (2011): 236-240.
  • 7. Newlands SD, Samudrala S, Katzenmeyer WK. Surgical treatment of gunshot injuries to the mandible. Otolaryngol Head Neck Surg. 2003;129(3):239-244. doi:10.1016/S0194-5998(03)00481-9
  • 8. Guevara C, Pirgousis P, Steinberg B. Maxillofacial Gunshot Injuries: A Comparison of Civilian and Military Data. J Oral Maxillofac Surg. 2016;74(4):795.e1-795.e7957. doi:10.1016/j. joms.2015.11.007
  • 9. Sali Bukhari SG, Khan I, Pasha B, Ahmad W. Management of facial gunshot wounds. J Coll Physicians Surg Pak. 2010;20(6):382-385.
  • 10. Çetingül, Erdoğan. Çene ve yüz travmatolojisi. Ege Üniversitesi Diş Hekimliği Fakültesi Yayınları, 2002.
  • 11. Fonseca RJ Marciani RD Turvey TA. Oral and Maxillofacial Surgery. 2nd ed. St. Louis Mo: Saunders/Elsevier; 2009.
  • 12. Oral and Maxillofacial Anatomy, The First Affiliated Hospital School of Medicine, Zhejiang University, Prof. Dr. Gu Xinhua, https://www.slideshare.net/deepak15/part1anatomy
  • 13. Lee KH, Epidemiology of mandibular fractures in a tertiary trauma center, Emergency Medicine Journal, 2008;25:565-568
  • 14. World World Health Organization. “Devastatingly Pervasive: 1 in 3 Women Globally Experience Violence.” Www.who.int, World Health Organization, 9 Mar. 2021, www.who.int/news/item/09-03-2021-devastatingly-pervasive-1-in-3-women-globallyexperience-violence.
  • 15. Basar F, Demirci N. Domestic violence against women in Turkey. Pak J Med Sci. 2018 May-Jun;34(3):660-665. doi: 10.12669/pjms.343.15139. PMID: 30034434; PMCID: PMC6041515
  • 16. Casale J, Bordoni B. Anatomy, Head and Neck: Infratemporal Fossa. [Updated 2022 Jul 25]. In: StatPearls [Internet]. TreasureIsland (FL): StatPearls Publishing; 2023 Jan-.
  • 17. Muddassar M, Arshad R, Rabbani S, Qureshi IS, Khattak IK, Rana Z. Management of Gunshot Injuries of Mandible with Open Reduction and Internal Fixation versus Closed Reduction and Maxillo-mandibular Fixation. Cureus. 2020;12(4):e7830. Published 2020 Apr 25. doi:10.7759/cureus.7830.
  • 18. Siddiqui S-u-d et al., Efficacy of open reduction and internal fixation in achieving bony union of comminuted mandibular fractures caused by civilian gunshot injuries, The Surgeon, https://doi.org/10.1016/j.surge.2019.
  • 19. Rana M, Warraich R, Rashad A, et al. Management of comminuted but continuous mandible defects after gunshot injuries. Injury. 2014;45(1):206-211. doi:10.1016/j.injury.2012.09.021.
  • 20. Muddassar M, Arshad R, Rabbani S, Qureshi IS, Khattak IK, Rana Z. Management of Gunshot Injuries of Mandible with Open Reduction and Internal Fixation versus Closed Reduction and Maxillo-mandibular Fixation. Cureus. 2020;12(4):e7830. Published 2020 Apr 25. doi:10.7759/cureus.783.
  • 21. Fagin AP, Dierks EJ, Bell RB, Cheng AC, Patel AA, Amundson MS. Infection prevalence and patterns in self-inflicted gunshot wounds to the face. Oral Surg Oral Med Oral Pathol Oral Radiol. 2019;128(1):9-13. doi:10.1016/j.oooo.2019.02.022.
  • 22. Powers DB, Will MJ, Bourgeois SL Jr, Hatt HD. Maxillofacial trauma treatment protocol. Oral Maxillofac Surg Clin North Am. 2005;17(3):341-vii. doi:10.1016/j.coms.2005.05.003.
  • 23. Sharma, Rohit & Jose, Anson. (2021). Gunshot Injuries of the Maxillofacial Region. 10.1007/978-981-15-1346-6_59.
  • 24. Arcuri F, Brucoli M, Baragiotta N, Stellin L, Giarda M, Benech A. The role of fat grafting in the treatment of posttraumatic maxillofacial deformities. Craniomaxillofac Trauma Reconstr. 2013 Jun;6(2):121-6. doi: 10.1055/s-0033-1333877. Epub 2013 Mar 8. PMID: 24436747; PMCID: PMC3721009.
There are 24 citations in total.

Details

Primary Language English
Subjects Surgery (Other)
Journal Section Case Report
Authors

Nihat Akbulut 0000-0001-6950-8214

Aseel Halawa 0009-0001-5663-362X

Early Pub Date May 29, 2025
Publication Date May 29, 2025
Submission Date May 14, 2025
Acceptance Date May 22, 2025
Published in Issue Year 2025 Volume: 4 Issue: 2

Cite

Vancouver Akbulut N, Halawa A. Gunshot injury to the mandible of a patient due to domestic violence with tough treatment process: A case report. EJOMS. 2025;4(2):39-42.

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