Vessel injuries of the head and neck presenting in mandibular fractures.

Abstract

Extracranial vascular injuries of the head and neck are relatively underdiagnosed in patients with acute trauma and can carry devastating sequelae. We wished to identify the correlation between mandibular fractures and injuries to major vessels of the head and neck. A retrospective review of our trauma registry was performed for the 1993-2007 period. The data on all mandibular fractures were collected. A total of 2288 patients presented to Parkland Memorial Hospital with mandibular fractures, of whom 47 (2%) had an injury to a major vessel of the neck. Nearly half, 23 (48.9%), were the result of high-velocity penetrating injuries, namely gunshot wounds, whereas 17 (36.2%) were the result of high-velocity blunt motor vehicle or motorcycle collisions. Patients who sustain a mandibular fracture in the setting of a high-velocity mechanism should be approached with the possibility of vascular injury of the great vessels of the neck kept in mind.