Risk Factors and Interventional Predictors for Postoperative Malunion and Nonunion in Adult Mandibular Fractures: A...

Area of Science:

• Oral and Maxillofacial Surgery
• Trauma Surgery
• Orthopedic Surgery

Background:

• Mandibular fractures are common oral and maxillofacial surgery injuries.
• Malunion and nonunion are significant, underreported complications of facial fracture healing.
• Malocclusion is a well-studied complication, but malunion/nonunion require further investigation.

Purpose of the Study:

• To evaluate risk factors, predictors, surgical variables, and management strategies for postoperative malunion or nonunion in mandibular fractures.
• To synthesize current evidence on complications following mandibular fracture repair.
• To identify key factors influencing healing outcomes in mandibular fractures.

Main Methods:

• Scoping review of PubMed, Embase, Web of Science, and Google Scholar (2000-2025).
• Inclusion of prospective and retrospective clinical studies on mandibular fracture management.
• Exclusion of systematic reviews, meta-analyses, case reports, pediatric, and non-English studies.

Main Results:

• Open reduction and internal fixation (ORIF) showed lower malunion/nonunion rates than closed reduction, especially for comminuted fractures.
• Delayed surgical intervention (6-7 days post-injury) increased malunion/nonunion rates.
• Risk factors include posterior fractures, comminution, smoking, alcohol abuse, poor patient education, and advanced age.

Conclusions:

• Timely ORIF with stable fixation is associated with reduced malunion/nonunion rates in mandibular fracture repair.
• Delayed intervention and inadequate patient education are significant risk factors for complications.
• Consideration of these factors is crucial for minimizing postoperative complications.