Factors Influencing the Decision-Making Process for Mandibular Fracture Internal Fixation: A Retrospective Study

This retrospective cohort study aimed to identify the critical factors influencing the selection of internal fixation for mandibular fractures. A total of 669 adult patients (with 72.05% male and the average age of 35.56 ± 12.36 y) who underwent open reduction and internal fixation (ORIF) at Peking University School and Hospital of Stomatology between January 2013 and April 2024 were analyzed. The study recorded demographic characteristics, clinical features and internal fixation modes. Bivariate and multivariate logistic regression analyses were used to evaluate associations between variables. Postoperative inflammatory complications (POICs) were also assessed. Fracture complexity ( P <0.001, OR=0.075, 95% CI: 0.023-0.242) and mandibular angle fracture ( P =0.008, OR=0.152, 95% CI: 0.038-0.606) were significantly associated with the selection of mandibular internal fixation. The rate of POICs was 5.82%. On the basis of 11 years of clinical cases and treatment experience at a single trauma center, this study indicates that fracture complexity and site are key factors influencing the selection of internal fixation mode. For mandibular fractures of higher complexity, especially those involving the angle, a more stable fixation mode should be prioritized.