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Updated: Sep 16, 2025

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Who's on Call? Mandibular Fracture Management at a Level I Trauma Center.

Allyson R Alfonso1,2, Maxime M Wang1,2, Alexis K Gursky2

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Journal of Clinical Medicine
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Oral and Maxillofacial Surgery, Plastic and Reconstructive Surgery, and Otolaryngology services differ in managing mandibular trauma. Despite varied approaches, overall complication rates remained similar across specialties.

Keywords:
complicationsfacial fracturefacial traumamanagementmandibular fractureoutcomes

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Area of Science:

  • Trauma Surgery
  • Oral and Maxillofacial Surgery
  • Plastic and Reconstructive Surgery
  • Otolaryngology

Background:

  • Facial trauma management involves Oral and Maxillofacial Surgery (OMS), Plastic and Reconstructive Surgery (PRS), and Otolaryngology (ENT).
  • Mandibular injuries represent a significant challenge, requiring coordinated care across disciplines.
  • Evaluating management strategies and outcomes is crucial for optimizing patient care.

Purpose of the Study:

  • To compare mandibular trauma management strategies and clinical outcomes among OMS, PRS, and ENT services.
  • To identify differences in operative versus non-operative fracture management and fixation techniques.
  • To assess whether variations in management affect overall complication rates.

Main Methods:

  • Retrospective chart review of 137 patients with isolated mandibular injuries from 2007-2016 at a Level I trauma center.
  • Data collected included patient demographics, fracture characteristics, management strategies (operative vs. non-operative, ORIF, MMF), and clinical outcomes.
  • Statistical analysis compared management approaches and complication rates between the three surgical services.

Main Results:

  • Assaults were the most common cause of injury (79.1%), with male patients predominating (95.3%).
  • Significant differences observed in operative vs. non-operative management (p < 0.001) and use of ORIF with or without MMF (p = 0.002) among specialties.
  • No significant difference in overall complication rates was found between the surgical services (p = 0.227).

Conclusions:

  • Surgical specialties exhibit distinct preferences for operative versus non-operative mandibular fracture management and the use of maxillomandibular fixation.
  • These variations in treatment decisions did not correlate with significant differences in overall patient complications.
  • Standardized outcome metrics may be beneficial despite differing management philosophies.