Bridging the Gap: A Hybrid Approach to Managing Multiple Edentulous Mandibular Fractures

The management of fractures in an atrophic edentulous mandible presents a significant surgical challenge due to compromised bone quality, reduced vascularity, and the absence of dental occlusion for guidance. Treatment must be carefully individualized to balance the need for stable fixation with the risks of invasive procedures in often geriatric patients. Here we present a case of 65-year-old male with multiple fractures of an edentulous mandible, including a parasymphysis fracture, unilateral coronoid fracture and bilateral intracapsular condylar fractures, following a road traffic accident. The patient was managed with a hybrid treatment approach, combining open reduction and internal fixation (ORIF) for the displaced parasymphysis fracture with closed reduction and stabilization of the condylar fractures and coronoid fracture using a custom-fabricated Gunning splint. This case report details the successful application of this combined modality, which provided adequate stability for bone healing while utilizing a conservative approach for the condylar segments.