The correlation between mandible fractures and loss of consciousness

The purpose of the study was to evaluate the relationship between mandible fractures and loss of consciousness (LOC) in patients sustaining maxillofacial trauma in a level I trauma center.

The study was a retrospective chart review performed at Lincoln Medical and Mental Health Center, a level I trauma center. A total of 225 hospital charts of patients who sustained mandible fractures during the period from 1997 to 2001 were reviewed. The site of fracture, number of fractures per mandible, degree of displacement, and mechanism of injury were recorded. Percentages of each category were compared among patients with positive and negative LOC. Patients with any concomitant craniofacial fractures or injuries were excluded from the study.

The incidence of LOC in patients sustaining mandible fractures was 17.6%. Young men were most likely to sustain mandibular fractures. The male-to-female ratio was 5.6:1. More than 70% of mandible fractures were due to interpersonal violence. Among various causes of interpersonal violence, use of a fist was most common. Overall, the number of fractures per patient, the incidence of singular versus multiple mandibular fractures, and the degree of displacement were less in the group with positive LOC. Body and angle regions were subjected to higher numbers of fractures, with slight variation among the 2 groups. The most common locations for mandibular fractures were the body (26% in negative LOC group; 42% in positive LOC group) and the angle (31% in negative LOC group; 26% in positive LOC group).

Nearly 1 in 5 mandible fractures was associated with positive LOC. The patient group with a positive LOC, on average, sustained fewer fractures. It is possible that when the mandible sustained fewer fractures, the dissipation of energy was reduced and more force was transmitted to the cranial vault, thereby resulting in a higher incidence of LOC.