Comprehensive surgical management of mandibular fractures

Mandibular fractures are common facial injuries. Classifications are combined and correlated with specific treatment modalities. Combined classification of fractures indicates the difficulty of treatment required. Many surgical techniques have been used and accepted as proper methods for reduction and fixation of mandibular fractures. Most studies advocate one technique as superior to others. The range of procedures now available include observation, closed reduction with maxillomandibular fixation, transoral reduction, intraosseous wire fixation, miniplate rigid osseous fixation, compression rigid osseous fixation, and external skeletal fixation. Our evaluation of the specific advantages of each modality indicates that selection of a specific procedure is individualized according to combined classification of the mandibular fracture, the surgical procedure's advantages and disadvantages, the patient's desires, and the surgeon's ability and clinical judgment. Case presentations demonstrate the principles involved in comprehensive surgical management of mandibular fractures. The techniques advocated produce anatomic reduction and restoration of physiologic function and aesthetics, with rare complications.