THE TREATMENT OF FRACTURES OF THE MANDIBLE

One hundred and eleven cases of mandibular fracture in 67 patients who were seen at the San Francisco General Hospital from 1960 to 1962 were reviewed. With the exception of two cases in which displaced fragments interfered with the mandibular range of motion, condylar fractures were successfully treated with closed reduction. Undisplaced fractures of the angle were treated successfully by intermaxillary fixation alone, but the significantly displaced fractures were treated by open reduction and interosseous wire fixation. Fractures of the anterior body and midbody were usually treated with closed reduction if adequate teeth were present for satisfactory intermaxillary fixation. Some fractures of the anterior body, particularly those in the region of the symphysis require open reduction because of the strong pull of the muscles in that area. In this series of patients, clinical infection and non-union were most commonly associated with fractures communicating with teeth. If open reduction is necessary, the results in this series suggest that it should be delayed until the oral tract left by extraction is healed. Prophylactic antibiotics did not appear to be of value in preventing infection or non-union in this small series of patients, although sufficient data were not available for a statistical conclusion.