Use of Botulinum Toxin Type A in the Open Reduction of a Mandibular Fracture in a Patient With Cerebral Palsy

Patient compliance is essential for stabilizing mandibular fractures and ensuring successful outcomes. However, uncontrollable movement disorders can greatly complicate the overall management. This case discusses the management of a mandibular body fracture in a 46-year-old male with dyskinetic cerebral palsy, without using maxillomandibular fixation. The patient fell from a wheelchair, resulting in a mandibular body fracture. He received open reduction and internal fixation, but maxillomandibular fixation was not feasible due to his condition. Severe bruxism led to excessive contractions of the masseter muscle, which complicated recovery. The patient underwent 2 revision surgeries, along with botulinum toxin injections and muscle relaxants. Three months after the final surgery, the patient recovered without complications, and radiographic follow-up confirmed proper fixation. This case demonstrates that for patients with dyskinetic cerebral palsy, combining open reduction and internal fixation with botulinum toxin injections can effectively manage mandibular body fractures and lead to successful healing.