Management of Mandibular Fractures in Nigeria A Retrospective Review of Cases from 2 Centres

Abstract

The aim of this study is to compare the pattern of mandibular fractures and to evaluate the outcome of treatment of these fractures by inter-maxillary fixation (IMF) in two government hospitals in Nigeria. A comparative bi-centre retrospective study of all consecutive patients with fractures of the mandible was carried out in hospitals: Ring-road State Specialist Hospital, (RRSH) Ibadan, in Oyo State and University of Port Harcourt Teaching Hospital, (UPTH) Port Harcourt, Rivers State. The study period at Ibadan was between April 2005 and April 2006, while that at Port Harcourt was between May 2006 and July 2007. A total of 19 consecutive patients attended the Ring Road State Hospital (RRSH) during the period. Fifteen of the patients were males while 4(21%) were females. Sixteen patients attended the University of Port Harcourt Teaching Hospital (UPTH) during the period, out of which 12 (75%) were males and 4 (25%) were females. The age range of the patients were 18-56yrs, mean 27.6years ± 12.4 and 4-50yrs mean 22.4years ± 11.6 respectively. The angle of the mandible was the most prevalent site of involvement in the RRSH group while the body of the mandible was more commonly involved in the UPTH group. Majority of the cases were due to road traffic accident either within or inter-cities. Two cases were due to gun-shots in UPTH while none was a result of gun-shots in RRSH. There were a total of 22 fracture sites in the 19 cases seen in RRSH, 16 patients had unilateral site and 3 had bilateral fractures. A total of 20 fractures were seen in the 16 cases in UPTH, 13 cases were unilateral fracture sites, 2 patients had bilateral and 1 patient had 3 sites of involvement. There was no significant difference between the means of the ages of the patients in the two groups. There was significant difference when the number of associated injuries was compared in both groups. Satisfactory healing of the fractures based on clinical and radiographic findings was achieved in all the cases seen in RRSH while15 of the 16 cases in UPTH had satisfactory outcome, 1 case had occlusal disharmony. Keywords: Pattern, mandible, fracture, inter-maxillary fixationNigerian Medical Practitioner Vol. 53 (1&2) 2008: pp. 19-23