Abstract
Unlike fractures of the remaining facial skeleton, fractures of the non-condylar part
of the mandible are invariably treated surgically, with the potential risk of further
iatrogenic injury. There is, however, a substantial evidence gap pertaining to the
potential non-surgical management of such injuries. The aim of this study was to determine
the outcomes of mandibular fractures treated with non-surgical management. All patients
with mandibular fractures who were referred to a large regional major trauma service
over a one-year period (1 January–31 December 2021) were identified. Those treated
with surgery or who sustained fractures of the condylar portion of the mandible were
excluded. Of all the patients referred to our unit with mandibular fractures, 34/155
(22%) underwent non-surgical management. In all cases plain radiographs demonstrated
minimal displacement. Thirty-two (94%) fractures were unilateral, of which 24 (70%)
involved the angle. Two of 34 patients subsequently required open reduction and internal
fixation due to pain that did not improve over time, one of whom declined. A minimally
extruded tooth in the fracture line, which altered the occlusion in one additional
patient, required minimal reduction of the enamel. The remaining patients healed without
complication six weeks after injury. Non- surgical management requires careful case
selection and regular follow up, so is of value to only a small proportion of patients.
Twenty-two per cent of all mandibular fractures were managed non-surgically at our
unit in one year, with a 97% success rate, demonstrating the potential utility of
this strategy in carefully selected cases.
Keywords
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Article info
Publication history
Published online: August 28, 2022
Accepted:
July 11,
2022
Received:
April 19,
2022
Identification
Copyright
Crown Copyright © 2022 Published by Elsevier Ltd on behalf of The British Association of Oral and Maxillofacial Surgeons. All rights reserved.