[Mandibular fractures. 2. Treatment, complications and late sequelae]

A total of 536 mandibular fractures were reviewed as regards treatment and complications. Among the 348 patients, 216 (62.1%) were hospitalized. Compared to other studies, many patients (31.2%), particularly with condylar fractures, were treated conservatively with soft diet only. Open reduction was used in 23.7% of the patients. Thirty five patients (10.1%) developed complications such as infection and/or delayed union. Postoperative infection was positively correlated to delayed union. Treatment-delay predisposed to primary, but not secondary infection. No correlation between fracture dislocation and development of complications was observed. A total of 209 patients came for follow-up after observation periods varying between one and six years. 48.8% had no symptoms. The most frequent late complications were occlusive change (22.2%) and sensory disturbances in the mental region. The mean ability to open the mouth was 48.5 mm. In one third of the patients with condylar fractures, the jaw deviated to the side of the involved condyle, but this finding did not interfere with function. Radiographically, shortening and, in many young patients, remodelling of the fractured condyle could be demonstrated. Teeth in the line of fracture should in general be preserved.