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Mandibular fractures - what a difference 30 years has made.
Chris Singleton1, Sankar Manchella1, Alf Nastri1
1The Royal Melbourne Hospital, 300 Grattan St, Parkville, VIC 3050, Australia.
The British Journal of Oral & Maxillofacial Surgery
|July 11, 2022
Summary
Mandibular trauma incidence increased over 30 years, with interpersonal violence remaining the primary cause. Management shifted significantly, reducing intermaxillary fixation and increasing semi-rigid internal fixation, leading to fewer complications.
Area of Science:
- Oral and Maxillofacial Surgery
- Trauma Surgery
- Epidemiology
Background:
- Mandibular trauma management has evolved over decades.
- Understanding current trends in mandibular fractures is crucial for optimizing patient care.
- A 30-year comparison provides insight into shifts in epidemiology and treatment.
Purpose of the Study:
- To characterize the epidemiology, management, and outcomes of mandibular trauma.
- To compare data from two distinct 30-year periods at a tertiary trauma center.
- To identify paradigm shifts in mandibular fracture treatment techniques and their impact.
Main Methods:
- Retrospective study comparing two cohorts of mandibular fracture patients (1985-1990 vs. 2011-2016).
- Data collected from The Royal Melbourne Hospital (RMH) Oral and Maxillofacial Surgery department.
- Analysis of patient demographics, fracture aetiology, injury patterns, management techniques, and complications.
Main Results:
- Increased incidence of mandibular trauma observed over 30 years.
- Young males remain the dominant demographic; interpersonal violence is the most common cause.
- Significant shift towards reduced intermaxillary fixation and increased use of semi-rigid internal fixation with extraoral approaches.
- Decreased complications including malocclusion, non-union, and permanent nerve injury were noted.
Conclusions:
- Mandibular trauma epidemiology shows an increasing trend, with consistent demographic and aetiological patterns.
- Modern surgical management has evolved, leading to improved outcomes and reduced complications.
- The study highlights significant advancements in treating mandibular fractures over three decades.

