Degloving Injuries of the Oral Cavity Change the Operative Approach to Fractures of the Anterior Segment of the Mandible

Abstract

No report to date describes the added risk traumatic, degloving injuries of the oral cavity may pose when treating fractures of the mandible. The authors describe the oral degloving injury, characterized by separation of periosteum and soft tissue of the anterior floor of the mouth from the inner cortex of the anterior segment. Vascular anatomy of the floor of the mouth is reviewed as a prelude to a description of pathomechanics of the injury and a case report. The higher incidence of oral degloving in youth and in young adulthood and parallels in elective, orthognathic surgery are identified. When this unusual clinical presentation occurs, and when open reduction of fractures of the anterior segment is chosen, a vestibular incision is best avoided. Instead, a submental or upper neck incision is chosen for sufficient exposure to allow reduction and the application of appliances. Meticulous closure of the intraoral void is achieved using one of two techniques, depending on the level of degloving.