Fractured drill bit in ORIF mandible - precautions and developing guidelines for its management

Figure 1. OPG showing fracture of the mandible, with fracture line running obliquely to the left side. Figure 2. Reduction & approximation of the fracture segments. Fractured drill bit in ORIF mandible - precautions and developing guidelines for its management Arvind Karikal 1 (a rvikarikal at gmail dot com) #, Arathi K 21 Department of Oral and Maxillofacial Surgery, A.B. Shetty Memorial. Institute of Dental Sciences, Nitte University, Mangalore 575018, Karnataka, India. 2 Department of Oraland Maxillofacial Pathology, A.J. Institute of Dental Sciences, RGUHS, Mangalore 575004, Karnataka, India# : corresponding author A case of a drill breakage during open reduction and internal fixation (ORIF) of a mandibular fracture is reported. Documentationand literature on this type of peri-operative complication is deficient. The clinical decision, diagnosis and surgical management of complicationare discussed. Introduction Fractures of the mandible which are not associated with any other fracture of the face or skeleton can be treated with or without inter-maxillaryfixation [1] [2] [3]. The reported complications of open reduction and internal fixation include: disturbed wound healing, infection, mal-union, non-union, hypoesthesia or paresthesia, impalement of tooth root or the inferior alveolar canal and fracture of mini-plate [4], facial asymmetry, fibrousunion [5]. Complications involving the breakage of surgical drills or mini-plates have been very rarely reported in maxillofacial literature. Drill bitfracture is usually encountered by every surgeon in his/her operating career; its causes, cases and methods to retrieve the same have rarely beenreported. Orthopedic literature shows an overall rate of 0.3 to 0.35% of instrument breakage [6] [7] [8]. The aim of the present report is to describean unusual case of a drill breakage during ORIF of a mandible fracture and its diagnosis, operative and postoperative management.