While it is admitted readily that the use of external pin fixation has a definite place in the management of fractures of the mandible, certain potential complications in its technical application may be overlooked. A patient recently under our care demonstrates a complication that we feel should be recorded.
A man suffered an oblique fracture through the right angle of his mandible. An early reduction was performed and the teeth were wired in occlusion. Because the mandible was edentulous posteriorly a Roger Anderson external pin fixation splint was substituted to stabilize the posterior fragment in the reduced position. The wires were removed after partial union to permit early motion and use.
At the time of application of the splint, one of the pins accidentally injured the underlying facial artery and vein. An immediate swelling developed that pulsated. The mass grew quickly to the size of a walnut. Pulsation continued for