Abstract
This single-centre retrospective study aimed to characterise the epidemiology, management,
and outcomes of mandibular trauma presenting to the same tertiary trauma centre 30
years apart, including key paradigm shifts in management and techniques. A total of
393 patients presenting with 665 mandibular fractures were managed by the Oral and
Maxillofacial Surgery department at The Royal Melbourne Hospital (RMH), Australia,
between 2011 and 2016. Data from a previous RMH paper of 205 patients presenting with
376 mandibular fractures between January 1985 and April 1990 were compared. Results
showed an increase in presentations (205 to 393 patients) with an increase in the
incidence of mandibular trauma (p = 0.0001), females (12% to 14%), and mean age (29
to 31.1) years. Young males remained the dominant cohort (86%) and interpersonal violence
(IPV) the most common aetiology (46% to 43%). Mandibular fractures remained commonly
associated with other systemic injuries (49% to 42%), occurring most frequently on
the left (49%), and at the angle (29.8%), with most occurring at two sites (53%).
Significant paradigm shifts in the management of mandibular trauma saw a reduced need
for intermaxillary fixation (76% to 30%, p = 0.0001), increased use of extraoral approaches
to the fracture, and the use of semi-rigid internal fixation along ideal lines of
osteosynthesis (29% to 87%, p = 0.0001). This demonstrated decreased complications
including malocclusion, non-union and delayed union, and permanent nerve injury. There
was no significant change in infection, dehiscence rates, and temporary nerve damage.
Keywords
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Article Info
Publication History
Published online: June 06, 2022
Accepted:
May 25,
2022
Identification
Copyright
© 2022 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
