Influence of Traumatic Brain Injury on Bone Healing Rate in Mandibular Fractures: A Prospective Comparative Study...

Accelerated bone healing in patients with traumatic brain injury (TBI) is well documented in long bone fractures but remains poorly studied in mandibular fractures. This study compared mandibular fracture healing rates in patients with and without TBI using high-frequency ultrasonography.

A prospective comparative study was conducted from June 2020 to November 2021 at a single tertiary care center. All patients with mandibular fractures were enrolled in the study. They were divided into two groups as Group 1-with TBI-and Group 2-without TBI. All patients underwent either open reduction and internal fixation or intermaxillary fixation. Fracture healing was assessed weekly for four weeks using high-frequency ultrasonography (6-15 MHz) to evaluate callus formation patterns.

A total of 77 patients were enrolled in the study, of which 22 were in Group 1 and 55 in Group 2. Groups were comparable for age (33.23 ± 13.48 vs. 35.80 ± 13.65 years, p = 0.391) and gender distribution (p = 0.977). Mean time to initial callus formation was significantly shorter in Group 1 (15.45 ± 1.96 days) compared to Group 2 (19.98 ± 3.04 days, p < 0.001). By the second week, soft callus was evident in 27.3% of TBI patients versus 9.1% without TBI (p = 0.007). By the fourth week, 72.7% of Group 1 showed hard callus formation compared to 27.3% in Group 2 (p < 0.001). Glasgow Coma Scale scores showed significant inverse correlation with callus formation timing (p < 0.001).

Mandibular fractures demonstrate accelerated healing in patients with TBI, with callus formation occurring approximately 4.5 days earlier. Ultrasonography provides an effective, radiation-free method for serial fracture assessment. These findings may inform surgical timing and follow-up protocols in polytrauma patients.