Symphysis Fractures Research Articles

The Periarticular Pelvic Clamp: An Indispensable Aid to Assist in the Narrowing of Facial Width in Mandibular Trauma.

Symphyseal fractures of the mandible with concomitant bilateral condylar fractures can often be a particularly challenging fracture pattern for the facial surgeon. Improper reduction of these fractures may lead to facial widening that proves difficult to correct secondarily. Here the authors describe a method to prevent this unwanted facial widening with the use of an orthopedic periarticular reduction clamp. This method allows for not only increased ease of reduction but also reduces the burden of assistance in manual reduction of the fracture.

Open Reduction of Unilateral Symphysis Fracture with Two Miniplates

Open Reduction of Unilateral Symphysis Fracture with Two Miniplates

Management of Multiple Fractures of the Parasymphysis and Angle of the Mandible

Introduction: Mandibular fracture is a fracture that often occurs in maxillofacial trauma. Fracture locations most often occur in the parasymphysis region and combined angle- parasymphysis fractures. Multiple mandibular fractures usually cause facial asymmetry and are challenging to reduce. Fracture treatment must be carried out immediately to restore function and aesthetics. This case report aims to discuss managing multiple mandibular fractures in the angulus and parasymphysis regions of the mandible. Case report: A 13-year-old male patient came to the emergency room at Hasan Sadikin Hospital with bleeding from the mouth caused by a two-wheeled traffic accident. Clinical and radiographic examination results revealed a fracture of the right para symphysis and left mandibular angle. The procedure carried out is Open Reduction Internal Fixation (ORIF). Discussion: Mandibular fractures often occur, and the leading cause is usually caused by driving accidents. Clinical examination and radiographs are needed so appropriate treatment can be carried out. In this case, treatment involves open reduction internal fixation (ORIF) extra and intra-oral approaches. Installation of 2 mini plates each in the symphysis region and angle of the mandible. Conclusion: Treatment for multiple fractures that occurred in the maxillofacial area, in this case, was internal fixation with open reduction (ORIF). The results of the treatment showed facial symmetry and normal chewing function. Keywords: Trauma, mandibular fracture, angulus, para symphysis, ORIF

A New Method in Dealing With Children's Condylar Fracture by Botulinum Toxin A Injection in Lateral Pterygoid Muscle.

Condylar is one of the most vulnerable sites to be traumatized in pediatric mandible fracture, while temporomandibular joint ankylosis might be the most severe complication of condylar fracture in children. There exists a long-time controversy on the treatment of condylar fractures in children. Considering the risk of facial nerve injury and a certain probability of absorption or even ankylosis after open reduction and internal fixation (ORIF) of condylar fractures, a series of nonsurgical approaches are preferred in cases without severe malocclusion or shortening of the ramus. Our treatment plan was carried out through combining procedures of Botulinum toxin A injection in lateral pterygoid muscle with ORIF of para symphyseal fracture; subsequently, a conservative way of the occlusal splint with elastic traction was performed. Three patients of bilateral or unilateral condylar fractures, aged between 2y and 6y, were involved in this treatment. After more than 1 year's follow-up, the occlusion was satisfactory in all patients. Condylar remodeling was approximately complete in 3 months, and no unwanted complications were observed. We may expect this method to offer a new idea when dealing with children's condylar fracture.

MR imaging spectrum of adolescent pubic symphyseal injuries/athletic pubalgia.

Magnetic resonance imaging (MRI) findings associated with athletic pubalgia are well documented in the adult literature. To describe the spectrum of MRI findings in adolescents with pubic symphyseal injuries/athletic pubalgia. This is an institutional review board approved, retrospective study of all patients < 18 years who were referred for MRI, over the last 10 years. Two pediatric musculoskeletal radiologists evaluated the MRI in consensus for the following findings: Chronic Salter-Harris (SH)-I equivalent fracture or asymmetric parasymphyseal ossific fraying, non-retractile muscular tear or retraction, and edema of the aponeurosis and arcuate ligament. Radiographs were also reviewed for Risser stage. Fifteen patients were identified (100% male, median age 17 years, IQR 16-17.6). Most patients (14/15, 93%) had either asymmetric parasymphyseal ossific fraying (4/15, 27%) or chronic SH-1 equivalent fracture (10/15, 67%) of the pubic symphysis, and all patients (15/15, 100%) had aponeurotic and arcuate ligament edema. Few patients had rectus abdominis muscular retraction (2/15, 13%), non-retractile muscular tear of the rectus abdominis (2/15, 13%), and/or adductor muscle (4/15, 27%). Risser stage was as follows: stages 0 (13%), 3 (7%), 4 (47%), and 5 (33%). The injuries in our limited data set were independent of skeletal maturity with no statistically significant association between any of the MRI findings and Risser stage. The MR imaging spectrum of adolescent athletic pubalgia differs from the described findings in adults due to skeletal immaturity. The cleft sign described in adults manifests in adolescents as asymmetric parasymphyseal ossific fraying and chronic SH-1 equivalent fractures.

Finite Element Analysis of New Modified Three-dimensional Strut Miniplate versus Conventional Plating in Mandibular Symphysis and Angle Fractures - An In vitro Study.

Mandibular fractures are common injuries during maxillofacial trauma, and currently, open reduction and internal fixation are considered gold-standard treatments. There is a wide discussion about which plates give the best outcomes. Hence, we are conducting a biomechanical comparison of two plates for mandibular symphysis and angle fracture with finite element analysis (FEA). The aim of this study was to do a comparative study of FEA between the conventional and our new modified three-dimensional (3D) strut miniplate in mandibular fractures at symphysis and angle regions. Finite element models of symphyseal and angle fractures of the mandible were developed. Each fracture model was then realigned and fixed by the conventional method 2.0 mm system, and our modified 3D strut plating method 2.0 mm system followed by the analysis of various stresses developed in plates and mandibular fracture area after application of load was observed in the study. The modified 3D strut plating system with 2.0 mm miniplates is significantly better in preventing displacement of fracture segments by better distribution of forces compared to the conventional plating system. Rest of the parameters were within the permitted limits. Modified 3D strut plating method was reasonably effective and superior in managing force-displacement compared to the conventional method of fixation for comminuted and unfavourable mandibular symphyseal fracture and angle fracture.

Detection and classification of mandibular fractures in panoramic radiography using artificial intelligence.

This study aimed to assess the performance of a deep learning algorithm (YOLOv5) in detecting different mandibular fracture types in panoramic images. This study utilized a dataset of panoramic radiographic images with mandibular fractures. The dataset was divided into training, validation, and testing sets, with 60%, 20%, and 20% of the images, respectively. An equal number of control panoramic radiographs, which did not contain any fractures, were also randomly distributed among the three sets. The YOLOv5 deep learning model was trained to detect six fracture types in the mandible based on the anatomical location including symphysis, body, angle, ramus, condylar neck, and condylar head. Performance metrics of accuracy, precision, sensitivity (recall), specificity, dice coefficient (F1 score), and area under the curve (AUC) were calculated for each class. A total of 498 panoramic images containing 673 fractures were collected. The accuracy was highest in detecting body (96.21%) and symphysis (95.87%), and was lowest in angle (90.51%) fractures. The highest and lowest precision values were observed in detecting symphysis (95.45%) and condylar head (63.16%) fractures, respectively. The sensitivity was highest in the body (96.67%) fractures and was lowest in the condylar head (80.00%) and condylar neck (81.25%) fractures. The highest specificity was noted in symphysis (98.96%), body (96.08%), and ramus (96.04%) fractures, respectively. The dice coefficient and AUC were highest in detecting body fractures (0.921 and 0.942, respectively), and were lowest in detecting condylar head fractures (0.706 and .812, respectively). The trained algorithm achieved promising performance metrics for the automated detection of most fracture types, with the highest performance observed in detecting body and symphysis fractures. Machine learning can provide a potential tool for assisting clinicians in mandibular fracture diagnosis.

Is Insurance Payer Associated With Hospital Admission of Emergency Department Patients With Mandible Fractures?

BackgroundThere is a lack of consensus on the optimal triage pathway for emergency department (ED) patients with mandibular fractures. It remains unclear if patient insurance payer predicts hospital admission given potentially competing logistical and health systems incentives. PurposeTo generate nationally representative estimates of the frequency of hospital admission and its association with primary insurance payer for ED patients with mandible fractures. Study DesignThis retrospective cohort study used the 2018 Nationwide Emergency Department Sample, the largest all-payer database in the United States, to identify patients with mandible fractures. The database includes a stratified sample with discharge weights to generate nationally representative estimates. Patients with other facial fractures and/or concomitant injuries that independently warranted admission were excluded. PredictorThe primary predictor variable was primary payer (public, private, self-pay, other/no-charge). Outcome VariableThe primary outcome variable was hospital admission(yes/no). CovariatesCovariates included patient-, medical/injury-, and hospital-related variables. Analyses: Descriptive statistics, along with bivariate and multivariate logistic regression with Bonferroni correction, were used to produce national estimates and identify predictors of admission. P<0.01 was considered significant. ResultsThe cohort included 27,238 weighted encounters involving isolated mandible fractures, of which 5,345(20%) were admitted. The payer for admitted patients was 46% public, 25% private, 22% self-pay, and 7% no charge/other. In bivariate analyses, public insurance was associated with a higher likelihood of admission than private insurance (RR 1.24, 95% CI 1.06-1.45), though there was no association in the multivariate model (OR 1.03, 95% CI 0.83-1.28). In multivariate analysis, higher Charlson Comorbidity Index (OR 1.32, 95% CI 1.18-1.48), alcohol-related disorder (OR 3.47, 95% CI 2.74-4.39), substance-related disorder (OR 1.43, 95% CI 1.20-1.71), and more mandible fractures (OR 3.08, 95% CI 2.65-3.59) were associated with admission. Compared to body fractures, sub-condylar (OR 3.83, 95% CI 2.39-6.14), angle (OR 3.53, 95% CI 2.84-6.09), and symphysis (OR 4.14, 95% CI 2.84-6.09) fractures had higher odds of admission. Finally, level I (OR 4.11, 95%C I 2.41-6.98) and level II (OR 3.16, 95% CI 1.85-5.39) trauma centers had higher odds of admission. ConclusionsIn 2018, 20% of ED patients with isolated mandible fractures were admitted. Several patient and hospital characteristics were predictors of admission. Insurance status was not associated with admission.

Incidence, Aetiology and Pattern of Maxillofacial Injuries in a Tertiary Trauma Hospital, Nepal: A 5-year Retrospective Study

Introduction: The aim of the present study was to evaluate the incidence, aetiology and patterns of maxillofacial injuries in a tertiary trauma hospital in Nepal.&#x0D; Methods: A retrospective analysis of all the maxillofacial trauma patients operated at the Department of Plastic, Cosmetic and Maxillofacial Surgery, B and B Hospital, Lalitpur, Nepal between 1st March, 2015 and 31st December, 2020 was performed. Data were collected for each patient in regards to age, gender, cause and nature and type of the injury and the treatment provided.&#x0D; Results: Among 409 patients operated in this period for maxillofacial injuries, 83% (n=356) were male and 17% (n=73) were female. Patients in the second and third decade of life were found to be more prone to sustain maxillofacial injuries. Road traffic accident was the most frequent cause (n=331; 77%) followed by physical assault (n=46; 10.7%) and falls (n=42; 9.7%). Mandible was the most commonly fractured bone (n=125; 26.5%). Fracture of parasymphysis, combined symphysis and condyle fracture and parasymphysis and angle fracture were the most common patterns of mandible fracture.&#x0D; Conclusions: The major cause of maxillofacial injuries among patients operated in our hospital was road traffic accident which directly reflects the poor traffic system and improperly planned roads.

Evaluation of Biodegradable Fixation Application for Jaw Fracture in Pediatric Patients

Background: The treatment of jaw fractures in pediatric patients need a special concern and different management than adult patients due to their dynamic and structural changes following their growth patterns. Treatment by open reduction and internal fixation (ORIF) using titanium or biodegradable plates as osteosynthesis material is indicated for displaced jaw fracture. Biodegradable fixation could be used as an alternative choice, using plates and screw that will decompose along with bone healing. Case: Two pediatric patients brought to RSUP Dr. Sardjito, Yogyakarta with complaints of jawbone fracture. The first patient was a 7-years-old woman diagnosed with mandibular symphysis fracture and a left mandibular kondilus fracture, while the second patient was a 15-years-old woman diagnosed with malunion of left maxillary fracture. Fracture treatment was performed using biodegradable fixation. The first patient was repositioned according to the anatomical state and the second patient the maxillary refracture was done before repositioning. Patients were evaluated clinically for up to three months postoperatively and radiological imaging was performed. Evaluation results show good jaw bone union, no malocclusion, no tooth mobility and no paresthesia in both patients. Intraoral wound dehiscence with exposed plate was found in the second patient at the vestibule of the left uper canine until premolar region and can be resolved by removal of the plates under local anesthesiaConclusions:. Biodegradable as an ideal osteosynthesis material for jaw fracture in pediatric patients

Study the Effect of Sodium Hyaluronate and Autologous Platelet Rich Fibrin on Symphysis Fracture Healing in Cat

Study the Effect of Sodium Hyaluronate and Autologous Platelet Rich Fibrin on Symphysis Fracture Healing in Cat

Treatment of mandibular symphysis fractures in a pregnant domestic cat

A pregnant domestic cat was found in an accident and taken to the Cikole Animal Hospital at Bandung. Physical examination showed that the cat's body temperature was 35.6℃ and bleeding was found in the eyes, nose, and mouth. Palpation of the dexter and sinister mandibular bones showed loose bones, and palpation of the abdomen showed that the fetus was still moving. Radiographic examination of the head showed that in the dorsoventral position, the mandibular bones were visible at the right and left mandibular symphysis separated by a radiolucent border. The cat was diagnosed with fracture of the mandibular bone symphysis. Therapy is performed by orthopedic surgery through the installation of a wire or surgical wire to connect the two dexter and sinister mandibular bones. After surgery, cats are administered antibiotics, anti-inflammatories, and multivitamins, with special consideration for pregnancy conditions. The dexter and sinister mandibular bones were fixed on the 8th day after surgery.

Morpho-Volumetric Changes of the Pharyngeal Airway With Traumatic Maxillofacial Injuries: A Retrospective Radiographic Study.

When dealing with traumatized patients, it is crucial to prioritize securing their airway. However, intubating someone who has sustained significant facial injuries can pose difficulties, as the narrow and altered shape of their upper airway may impede their ability to open their mouth. In light of this, the purpose of this study is to evaluate the volumetric and morphological alterations to the upper airway resulting from facial trauma by utilizing computed tomography (CT) scans. This is a single-centered retrospective analytical study. This study included CT scans of patients with traumatic facial injuries admitted to King Fahad Hospital in Madinah, Saudi Arabia. Study variables included age, gender, body mass index (BMI), fractured bones, airway symmetry, and airway volume. Using the 3D Slicer software (Slicer Community, USA), a three-dimensional model of the pharyngeal airway was constructed from the CT scan to evaluate symmetry and volume. IBM SPSS Statistics for Windows, version 23 (released 2013; IBM Corp., Armonk, New York, United States) was used to analyze data. Among the screened scans, 136 cases with traumatic facial injuries were included in the study. Age ranged from four to 91 years, with a mean of 28.26 (±14.9). Mandibular and zygomatic fractures were the most common, with 71 (52.2%) and 69 (50.7%) cases, respectively. The pharyngeal airway was symmetric in 111 (81.6%) cases and not symmetric in the other 25 (18.4%) cases. A significant association was found between the side of the fracture and airway asymmetry in mandibular fractures (p-value = 0.03). The total airway volume in the displaced mandibular fractures showed a statistically significant decrease (p-value = 0.019). The fracture sites were not statistically linked to airway asymmetry except for parasymphyseal and symphyseal fractures, with a p-value of 0.038 and 0.041, respectively. The study findings suggest that the pharyngeal airway is not usually compromised in most facial bone fractures; however, bilateral displaced mandibular fractures have the potential to diminish the pharyngeal airway volume, especially in fractures involving the symphysis and parasymphysis area.

Management of a pediatric mandibular symphysis fracture with a custom acrylic cap splint

ABSTRACT Traumatic dentoalveolar injuries in pediatric patients are a common occurrence. Treatment strategies for managing mandibular fractures in pediatric patients are dissimilar to that of adult patients. The dynamic nature of bone, developing tooth buds, parent’s levels of apprehension, and the patient’s level of cooperation are some of the factors which dictate the treatment of choice. Treatment rendered should aim at the stabilization of fractured segments with minimum invasiveness. The purpose of this case report is to describe the management of mandibular symphysis fracture in a 1-year-old boy using an acrylic splint which is stabilized with circummandibular wiring.

Conservative management of mandibular fractures in pediatric patients during the growing phase with splint fiber and ligature arch wire

PurposeThe purpose of this article is to discuss the effective management of mandibular fractures in pediatric patients during the growing phase of the mandible using splint fiber and ligature wire.MethodsA retrospective study examined pediatric patients with mandibular fractures who were treated using the splint (Quartz) fiber and ligature wire technique at the Stomatology Hospital of Xi’an Jiaotong University from August 2021 to January 2023. Data on gender, age, location or site of the fracture, and development of tooth stage were collected from the patient’s medical records. Descriptive statistics were used to analyze the data and evaluate the effectiveness of the splint (Quartz) fiber technique for treating mandibular fractures in pediatric patients.ResultsOut of 256 subjects, 6 pediatric patients with mandibular fractures were selected, resulting in an incidence rate of 2.34% with an equal sex ratio. Mental or symphysis fracture was the most common site for fracture in children, accounting for 100% of cases. Right mandibular angle fracture was observed in 16.7% of patients, while 50% of the group (3 individuals) suffered from left condylar fracture and 16.7% had a bilateral condylar fracture. Treatment with Quartz splint fiber and circumdental arch wiring using ligature wire was successful with no observed post-treatment complications or malocclusion. The splint fiber was worn for 30 days and the circumdental arch wiring was for the same. Healing of bone fracture yields good results after 12 weeks. Follow-up care is crucial to monitor for complications, in this study, no post-treatment complications were observed.ConclusionThe treatment of pediatric mandibular fractures is complex and requires careful consideration of various factors. Conservative management should be the first choice, with open reduction and internal fixation reserved for specific cases. The use of quartz splint fiber and ligature wire is an effective treatment option for stabilizing the mandible and providing occlusal stability in growing children. A fiber splint along with ligature wire can also be used as an alternative treatment to avoid any adverse effects on the growth and development of the mandible and permanent teeth. A multidisciplinary approach is essential to achieving the best outcomes for pediatric patients with mandibular fractures.

Frequency and Pattern of Presentation of Mental Nerve Injury During Para Symphysis Fracture

Aim: The mandibular fracture at the parasymphysis is the most often seen fracture of a facial bone. The occurrence of anaesthesia or paraesthesia in the skin and mucous membrane within the distribution of the mental nerve may be seen due to mental nerve injury resulting from fractures in the Parasymphysis region. This condition has the potential to impact the overall well-being of affected individuals. Objective: To determine the Frequency and pattern of presentation of mental nerve injury during Para symphysis fracture. Method: The present research is an observational and descriptive investigation including a sample of 65 patients diagnosed with parasymphysis fracture. The study was done at the Nishter Institute of Dentistry in Multan, Pakistan, spanning from September 2021 to February 2023.Following the endorsement of the research by the Ethical Review Board of the hospital, patients were recruited using a non-probability sequential sampling method. The researchers used clinical neuro-sensory testing (NST) as a means of evaluating nerve damage and determining the specific kind of neurosensory impairment that occurred subsequent to a para symphysis fracture. A specifically prepared proforma is used as a tool for data collecting. The data underwent statistical analysis, and findings and observations were derived from the analysis. Results: The study assessed the incidence of mental nerve damage in instances with Para symphysis fracture, revealing that 23 cases (35%) exhibited the presence of mental nerve injury, whereas it was missing in 42 cases (65%). The study observed a total of 23 individuals, consisting of 17 males and 6 females, who were diagnosed with mental nerve damage. The most often encountered neurosensory problems experienced by patients after surgery are paraesthesia. Additionally, it has been shown that the leading cause of parasymphysis fracture in both males and females is road traffic accidents (RTA). Conclusions: Road traffic accidents (RTAs) have been identified as a significant factor contributing to parasymphysis fractures. These fractures may result in the development of neurosensory deficits either as a consequence of the initial trauma or as a complication after surgical intervention. It has been seen that such fractures can lead to persistent complications and a decrease in overall quality of life. Additionally, it is essential to conduct additional research studies that cover a longer duration and include a bigger cohort of patients. Keywords: Mandibular fracture, Mental nerve, Paraesthesia, Trauma

Control of Mandibular Width With 3D Printed Occlusal Splint in Children With Multiple Mandibular Fractures.

The fracture of mandibular symphysis combined with bilateral condylar fractures often leads to changes in the width of the mandible, which significantly widens the face of the child. Therefore, it is necessary to reposition the mandible through accurate adduction. To ensure that the mandible can be accurately repositioned, a 3D printed occlusal splint was used. Bilateral maxillomandibular fixation screws were implanted. The 3D printed occlusal splint was located on the maxillary dentition and fixed to the maxillomandibular fixation screws with wire loops. The reference basis for adduction is to make the mandibular dentition located in the occlusal splint. The absorbable plate was contoured according to the restored model and fixed at the fracture site. The 3D printed occlusal splint was retained in the maxillary dentition for two months. Postoperative computed tomography showed that the mandible had been adducted according to the preoperative design. Two months of follow-up showed that the child's facial development, mouth opening type, occlusion, and range of motion were good. It is especially suitable for children with mandibular symphyseal fractures accompanied by bilateral condylar fractures.

Can Fracture Reduction be Attempted Through a 3D-Printed Guide Template Without Maxillomandibular Fixation?

Computer-aided design and manufacturing is widely used in clinical practice. This technology may change existing methods for mandibular fracture management. The purpose of this in-vitro study was to determine if the reduction for mandibular symphysis fracture is performed without maxillomandibular fixation (MMF) using 3-dimensional (3D)-printed template. This was an in-vitro study and had the character of a proof-of-concept study. The study was planned using the existing 20 pairs of intraoral scan and computed tomography data. The mandibular model STL file was created by merging the STL file obtained for the bimaxillary dentitions with the computed tomography DICOM file, and this was set as the original model. In the original model, STL file of fracture model of mandibular symphysis was created using computer-aided design. A template similar to a wafer or an implant guide was manufactured from restoring the own occlusion, and the mandibular fracture model was reduced and fixed using the 3D-printed template and wire, and this was set as the experimental group. The 3D coordinate system error was measured at 6 landmarks and statistically compared using scan data between models of the groups. Reduction techniques with MMF or without MMF using guide template for mandibular fracture model. The 3D coordinate system error (mm). The position of landmarks. The Mann-Whitney U test, student's t-test, and the Kruskal-Wallis test were used to analyze the coordinate errors between the landmarks. A P value of < .05 was considered statistically significant. The 3D error value of the control and experimental group were 1.06±0.63mm (range: 0.11 to 2.92mm) and 0.96±0.48mm (range: 0.2 to 2.95mm), respectively. There was no statistical difference between the control and experimental group. There was a statistically significant difference in the lower 2 and lower 3 landmarks compared to the upper 1 (P=.001 and .000, respectively) before and after the reduction in the experimental group. This study demonstrates that the reduction using a 3D-printed guide template for the mandibular symphysis fracture could be possible even without the MMF.

Biomechanical evaluation of two internal fixation systems for the treatment of mandibular symphyseal fracture

Due to the disadvantage of maxillomandibular fixation, the semi-rigid and rigid internal fixations have been employed to provide early mouth motion. To find the proper fixation and adequate stability, the biomechanical performance of these systems was assessed using Finite Element (FE) method. The 3D mandible model with a symphyseal fracture, teeth, periodontal ligament, and fixation devices were created for the FE analyzes. The bone structure was determined as a transverse isotropic whereas the fixation devices were titanium. The load includes Masseter, Medial Pterygoid, and Temporalis muscular forces as well as the occlusal forces acting on first molars, canines, and incisors. The maximum stress occurs at the center of fixation devices at symphyseal fracture. The maximum stress values were 877.4 MPa for the reconstruction plate and 646.8 MPa for the mini-plates. The plates maintained the fracture width at mid-region better than superior and inferior. The maximum fracture gap were 1.10 and 0.78 mm for reconstruction plate and mini-plates, respectively. The fracture site's elastic strain stabilized with the reconstruction plate was 1089.0 microstrains and with the mini-plates was 399.6 microstrains. The treatment of a mandibular symphyseal fracture using a mini-plates provides more adequate fracture stability for new bone formation and mechanically safer than locking reconstruction plate. Mini-plates fixation was able to control the fracture gap better than the reconstruction plate. Mini-plates technique was considered as the first choice of internal fixation, however, a reconstruction plate can also be used in case of unavailability and complication related to mini-plating.

Mandibular fractures at a tertiary health care facility: a pilot study

Background: Facial trauma patients were analyzed to determine the incidence, type, presentation, management, and outcome of fractures of the mandible. Methods: The 61 patients admitted in the trauma units of Dayanand medical college Ludhiana were analyzed prospectively during a period of two years (January 2010-December 2012). Results: In patients with multiple fractures, the common combination included zygoma and mandible (35.2%) and Le Fort II, mandible and nasoethmoid (41.2%). Out of 35 patients with mandible fractures, 8 had bilateral and 27 had single fractures making a total of 43 fractures. The body of mandible. 46.5% followed by the angle 34.8%, symphysis 9.3%, and parasymphysis 4.6% ramus and condoyle in 2.3% each were seen. Of the single mandibular fractures, the body and angle were almost equally affected in 48% and 44% cases, respectively. Isolated fracture of symphysis and parasymphysis was seen in 3.7% cases each. Isolated fracture of the ramus or condyle was not seen in any case. Half of the angle fractures were treated by wiring while shown in 1/4th each, plating and external fixation was used for treatment. Almost half (6/13) of fractures of the body were treated with external fixation. All bilateral fractures were treated with bone plating. Conclusions: Road traffic accidents are the major cause of these fractures. Mandibular fractures are commonly associated with fractures of other facial bones. The fracture line commonly seen is in the body of mandible, followed by the angle.