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Related Experiment Videos

Treatment considerations for comminuted mandibular fractures.

Edward Ellis1, Oscar Muniz, Kapil Anand

  • 1Division of Oral and Maxillofacial Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75390-9109, USA. Edward.Ellis@UTSouthwestern.edu

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
|August 9, 2003
PubMed
Summary

Open reduction with stable internal fixation offers low complication rates for comminuted mandibular fractures. Alternative treatments like maxillomandibular fixation (MMF) or external pin fixation may be necessary for severe injuries.

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Trauma Surgery
  • Orthopedic Surgery

Background:

  • Comminuted mandibular fractures present complex treatment challenges.
  • Understanding treatment modalities and their outcomes is crucial for patient care.

Purpose of the Study:

  • To assess treatment methods and outcomes in a large cohort of patients with comminuted mandibular fractures.
  • To identify factors influencing complication rates in these injuries.

Main Methods:

  • Retrospective analysis of 196 patients with 198 comminuted mandibular fractures over a 10-year period.
  • Data collected included demographics, treatment type (closed reduction with maxillomandibular fixation (MMF), open reduction with internal fixation, external pin fixation), and outcomes.
  • Descriptive and nonparametric statistics were used for data analysis.

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Main Results:

  • The mandibular body was the most frequently affected region, with altercations and gunshot wounds being common causes.
  • Open reduction with stable internal fixation was the most common treatment (146 fractures), associated with a 10.3% complication rate.
  • External pin fixation had the highest complication rate (35.2%), often used for more severe injuries. Overall complication rate was 13%.

Conclusions:

  • Open reduction and stable internal fixation are associated with favorable outcomes and low complication rates when feasible.
  • For severe or non-amenable fractures, closed reduction with MMF or external pin fixation serve as necessary alternatives.
  • Treatment choice should consider fracture severity and amenability to fixation.