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 & 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 was compared. Results showed an increase
in presentations (205 to 393 patients) with an increase in the incidence of mandibular
trauma (P=0.0), females (12% to 14%) and mean age (29 to 31.1). 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=0.0), 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=0.0).
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
Accepted:
May 25,
2022
Received in revised form:
May 23,
2022
Received:
February 10,
2022
Publication stage
In Press Accepted ManuscriptIdentification
Copyright
© 2022 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
