Management of Mandibular Fractures at a High-Volume Educational Center-A Retrospective Study

Background: Mandibular fractures are often treated with open reduction and internal fixation in order to restore function and anatomy. This study analyzes postoperative complications and outcomes over one year at a high-volume teaching hospital, focusing on fracture types, treatment methods, and the impact of providers' experience. Methods: This retrospective study included patients 12 years of age or older with mandibular fractures resulting from trauma during a 1-year period, January-December 2022 in a level 1 trauma center. Medical records were reviewed, and patient data was collected. Patients were categorized into 3 groups: Group 1 (surgical treatment), Group 2 (closed treatment, i.e., dental splints, arch bars/eyelets), and Group 3 (observation/soft diet). The results were tabulated, and standard descriptive statistics were used. Results: 141 patients with 223 mandibular fractures met inclusion criteria. Throughout all groups, 18 surgically treated patients (12.7%) and one patient treated with arch bars (0.07%) required additional unintended surgical procedure such as plate removal with/without re-plating, or orthognathic surgery for occlusal correction. Conclusions: The complication rates in this cohort align with the existing literature, though variations may origin from limited sample size, short follow-up and patient comorbidities. The involvement of less experienced surgeons during on-call hours most likely contributed to outcome variability. Despite challenges, most patients had favorable outcomes.