A Stepwise Sequence for the Management of Extensive Comminuted Mandible Fractures: A Retrospective Case Series

Management of comminuted mandible fracture can be either conservative or open reduction and internal fixation (ORIF). The purpose of the present case series is to reinforce ORIF for extensive comminuted mandible (ECM) fractures. The specific aim is to present a stepwise approach to manage these fractures.

The investigators designed a retrospective study in a tertiary care hospital in India. The study sample consisted of patients of extensive comminuted mandible fracture managed with ORIF. The patients having an extensive comminuted fracture of mandible with complete records were included as study subjects, irrespective of age and gender. The data collected were age, gender, mode of injury, type of fractures, concomitant injuries, timing of treatment, the outcomes and complications, if any. The authors have described a stepwise approach to convert a complex task into easy task to achieve better results.

In these retrospective case series, the authors have presented 5 cases of severely comminuted mandible fracture managed with ORIF from January 2022 to March 2023. All patients were young with age range was 17-27 years. The male to female ratio was 1.5:1. The mode of injury was fall from height in 3 cases and road traffic accident in 2 cases. Out of 5 patients, 4 had concomitant orthopedic injury and rest 1 had isolated maxillofacial injury. The follow-up ranged from 48 days to 15 months. No major complication was seen in any of the patient.

Open reduction and internal fixation provide promising results for extensive comminuted mandible fractures with minimal complication rate. Sequential stepwise approach should be followed in these fractures.