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Sharma G, Shukla D, Bhola N. An Isolated Unilateral Condylar Head Fracture in an Adult Female: A Case Report. Cureus 2024; 16:e62813. [PMID: 39040755 PMCID: PMC11260668 DOI: 10.7759/cureus.62813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 06/20/2024] [Indexed: 07/24/2024] Open
Abstract
Mandible fractures are one of the most common facial fractures. Within the mandible, the condylar process fractures have the highest frequency of occurrence. This fracture type is associated with cases of assaults and falls. Fractures of the condylar head are frequently missed on clinical examination if the ramus height shortening is absent. These types of fractures have a higher incidence in the pediatric population. Condyles tend to fracture with other anatomical subsites of the mandible. The isolated fracture of a single condylar component is less common. This report highlights the unusual case of an isolated unilateral condylar head fracture in an adult female following a road traffic accident (RTA). This case report attempts to discuss the incidence rate of such types of fractures and the controversies surrounding them.
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Affiliation(s)
- Gauri Sharma
- Oral and Maxillofacial Surgery, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Deepankar Shukla
- Oral and Maxillofacial Surgery, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Nitin Bhola
- Oral and Maxillofacial Surgery, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Retrospective clinical study of mandible fractures. Maxillofac Plast Reconstr Surg 2022; 44:36. [PMID: 36322224 PMCID: PMC9628403 DOI: 10.1186/s40902-022-00365-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022] Open
Abstract
Background As society becomes more complex, the incidence of mandibular fractures is increasing. This study aimed to analyze the incidence and type and identify etiological factors of mandibular fractures to use them in future treatments. Material and methods Data were collected from 224 patients who visited the department of oral and maxillofacial surgery at the Kyung Hee Medical Center dental hospital during a 6-year period (2016 to 2021). A logistic regression model was used for data analysis. Results In a total of 224 patients, 362 fractures were appeared. The average age of the patients was 34.1 years, with the highest incidence in the 20s. And the ratio between male and female was 4.09:1. Symphysis fractures were the most prevalent of all patients (52.7%), followed by unilateral condyle (37.1%), angle (36.2%), bilateral condyle (9.4%), body (8%), and coronoid (2.2%). The most common cause of fracture was daily-life activity (57.6%), followed by violence (30.4%), traffic accidents (8.5%), and syncope (3.6%). Patients with symphysis fracture were at low risk (OR < 1) of angle, body, and unilateral condyle fractures. Similarly, patients with unilateral fracture were at low risk (OR < 1) of symphysis, angle, body, and others site fractures. In contrast, patient with bilateral condyle fracture were at high risk (OR > 1) of coronoid fractures. And younger patients were high risk of mandibular angle fractures. Conclusion Through this study, it was confirmed that etiological factors of mandibular fractures were like those of previous studies.
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Pereira RMA, Barbosa OC, Basílio AFP, Santana ACS, Paula DMD, Marangon H. Surgical Decompression of the Orbit due to Frontal Bone and Roof of the Orbit Fractures - A Case Report. Ann Maxillofac Surg 2021; 10:495-500. [PMID: 33708604 PMCID: PMC7944003 DOI: 10.4103/ams.ams_87_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/05/2020] [Accepted: 05/07/2020] [Indexed: 11/24/2022] Open
Abstract
Trauma in the face region has a very varied etiology and can be associated with several important structures. Isolated fractures in the orbit region correspond to about 4 to 16% of all facial fractures and this incidence increases to 30 to 55% if we take into account fractures that expand to extraorbital regions. The present clinical report aims to describe the case of a male patient, 21-years-old, victim of a motorcycle accident with facial trauma and traumatic brain injury due to frontal collision. Clinical and imaging examinations showed multiple fractures in the face with herniation of brain mass to the orbital region and consequent extrusion of the eyeball. Surgical procedures were performed to reduce and fix fractures and multidisciplinary treatment aimed at preserving vision and brain integrity. Thus, the surgical approach and the multidisciplinary treatment led to an excellent prognosis attested by the one-year postoperative period.
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Affiliation(s)
- Rafael M A Pereira
- School of Dentistry, University Center of Patos de Minas, Patos de Minas, Minas Gerais, Brazil
| | - Otávio C Barbosa
- School of Dentistry, University Center of Patos de Minas, Patos de Minas, Minas Gerais, Brazil
| | - Ana Flávia P Basílio
- School of Dentistry, University Center of Patos de Minas, Patos de Minas, Minas Gerais, Brazil
| | - Anna Cecilia S Santana
- School of Dentistry, University Center of Patos de Minas, Patos de Minas, Minas Gerais, Brazil
| | - Douglas M De Paula
- School of Dentistry, University Center of Patos de Minas, Patos de Minas, Minas Gerais, Brazil
| | - Helvécio Marangon
- School of Dentistry, University Center of Patos de Minas, Patos de Minas, Minas Gerais, Brazil
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Craniofacial Morphometric Features Associated With Pericondylar Fractures of the Mandible. J Craniofac Surg 2019; 30:2065-2068. [PMID: 31490441 DOI: 10.1097/scs.0000000000005960] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The research aimed at investigating potential correlations between craniofacial morphological measurements and mandibular pericondylar fractures, based on a retrospective study of 380 mandible fractures treated in our department, during 2010 to 2017. Predictors included morphological measurements and features. Primary outcome was presence of pericondylar fracture; 133 pericondylar fractures were found, including subcondylar, condylar neck, and condylar head fractures. Condylar neck fractures showed negative correlations with condylar neck width (5.7 mm versus 6.7 mm sagittaly, and 6.1 mm versus 6.8 mm coronally, respectively). Gonial angle (117.3 degrees versus 128.7), and mandibular length 106.2 mm versus 110.4 mm, respectively) showed negative correlation with all pericondylar fractures. Ramus height correlated positively with pericondylar fractures (53.6 mm versus 51.2 mm, respectively). Thus, our results showed condylar neck width was a predictor for condylar neck fractures. In addition, individuals suffering from pericondylar fractures had significantly smaller gonial angles, longer ramus height, and shorter mandibular length. These morphologic features are characteristic of individuals with decreased anterior facial height. Our results corroborated a previous study we had conducted, which suggested that increased anterior vertical growth correlates with angle fractures.
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The Relation Between Morphometric Features and Susceptibility to Mandibular Angle Fractures. J Craniofac Surg 2018; 29:e663-e665. [PMID: 30222685 DOI: 10.1097/scs.0000000000004730] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The study was aimed to determine possible relations between skeletal morphologic parameters to mandibular angle fractures. Retrospective study of 100 patients suffering from mandibular fractures and treated in the Rambam Health Care Campus between the years 2013 and 2017 was conducted. Predictor variable was facial skeletal morphologic features as derived from the measurements. Outcome variable was mandibular angle fractures. About 42 patients suffered from angle fractures. Gonial angle (131.3° versus 118.1°), condylar neck width (8.3 mm versus 6.8 mm sagittaly and 7.1 mm versus 5.8 mm horizontally), and wisdom tooth prevalence and impaction were positively correlated to the fracture. Ramus height (48.3 mm versus 53.4 mm) was negatively correlated to angle fractures. Many reports in the literature show positive relations between impacted 3rd molars and angle fractures, yet only sporadic reports describe relations between facial fractures and facial features. Our results showed the predictable positive relation between angle fractures and 3rd molar prevalence and impaction. Yet surprisingly, we found unequivocal significant positive correlation between angle fractures to gonial angle and condylar neck width and negative correlation to ramus height. Based on the correlation to the gonial angle and ramal height, it is concluded that enlarged anterior vertical growth is a predictor for angle fractures, as are condylar neck width, and wisdom teeth.
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Esses DFS, Costa FWG, Sá CDL, Silva PGB, Bezerra TMM, Carvalho FSR, de Medeiros JR, Soares ECS. Occupational group, educational level, marital status and deleterious habits among individuals with maxillofacial fractures: retrospective study. Med Oral Patol Oral Cir Bucal 2018; 23:e13-e22. [PMID: 29274150 PMCID: PMC5822534 DOI: 10.4317/medoral.21969] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 09/05/2017] [Indexed: 11/24/2022] Open
Abstract
Background To investigate the occupational profile, educational level, marital status and deleterious habits to the health of patients with maxillofacial fractures of a population of northeastern Brazil. Material and Methods A retrospective study of patients records admitted to the Division of Oral and Maxillofacial Surgery at the Walter Cantídio University Hospital (Fortaleza, Brazil) who sustained maxillofacial fractures was conducted in the period between 2006 and 2015. Results A total of 338 patients rendered 355 fractures. Males were the most affected (p<0.001), with prevalence in the third decade of life (p<0.001). There was a predominance of motorcycle accidents (p<0.001), home workers (p<0.001), low educational status (p = 0.032), and no cigarette use (p<0.001) or alcohol (p = 0.023). Fractures of the zygomatic-orbital complex were the most prevalent in the sample (p<0.001). Conclusions The sociodemographic profile exerted a significant influence on the epidemiological profile of maxillofacial fractures in a Brazilian population during the study period. Key words:Epidemiological studies, trauma, facial bones.
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Affiliation(s)
- D-F-S Esses
- Rua Alexandre Barauna 949 - Rodolfo Teofilo, Postal Code: 60430-160 Fortaleza, Ceara, Brazil,
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Afrooz PN, Bykowski MR, James IB, Daniali LN, Clavijo-Alvarez JA. The Epidemiology of Mandibular Fractures in the United States, Part 1: A Review of 13,142 Cases from the US National Trauma Data Bank. J Oral Maxillofac Surg 2015; 73:2361-6. [DOI: 10.1016/j.joms.2015.04.032] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 04/22/2015] [Accepted: 04/23/2015] [Indexed: 10/23/2022]
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Ghodke MH, Bhoyar SC, Shah SV. Prevalence of mandibular fractures reported at C.S.M.S.S Dental College, aurangabad from february 2008 to september 2009. J Int Soc Prev Community Dent 2014; 3:51-8. [PMID: 24778980 PMCID: PMC4000912 DOI: 10.4103/2231-0762.122428] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Aim: The aim of this study is to determine the etiology, frequency of mandibular fractures among different age and sex, to determine the frequency of anatomic distribution, and to report the different modalities of treatment provided to the patients reported at our institution from February 2008 to September 2009. Materials and Methods: All patients fulfilling the selection criteria and having mandible fracture were selected for the study. Patient information was collected by means of a medical data form specifically designed for the present study. The values were subjected to Z and Chi-square tests. Results: Out of 35 patients, thirty one were males (88.57%) and four were females (11.43%) with a male:female ratio of 8:1. We found a peak occurrence in young adults, aged 21-30 years (n = 15, 42.86%). In case of etiology of fracture, road traffic accidents (RTAs) was the most common (n = 25, 71.43%) and condyle was most frequently involved site (n = 19, 38.78%). In most (n = 16, 45.71%) of the patients, an open reduction and rigid internal fixation using bone plate and screws was done. Conclusion: In the present study, the prevalence of mandible fractures was more prevalent in male patients, especially during the 3rd decade of life. The most common cause was road traffic accident and the more frequently affected region was condyle of the mandible. Open reduction and rigid internal fixation using miniplates and screws was the most commonly used treatment.
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Affiliation(s)
- Monali H Ghodke
- Department of Oral and Maxillofacial Surgery, Sinhgad Dental College and Hospital, Pune, Maharashtra, India
| | - Subhash C Bhoyar
- , Chhatrapati Shahu Maharaj Shikshan Sanstha Dental College and Hospital, Aurangabad, Maharashtra, India
| | - Seemit V Shah
- , Chhatrapati Shahu Maharaj Shikshan Sanstha Dental College and Hospital, Aurangabad, Maharashtra, India
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Rashid A, Eyeson J, Haider D, van Gijn D, Fan K. Incidence and patterns of mandibular fractures during a 5-year period in a London teaching hospital. Br J Oral Maxillofac Surg 2013; 51:794-8. [DOI: 10.1016/j.bjoms.2013.04.007] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Accepted: 04/07/2013] [Indexed: 11/30/2022]
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Kisnisci R. Management of Fractures of the Condyle, Condylar Neck, and Coronoid Process. Oral Maxillofac Surg Clin North Am 2013; 25:573-90. [DOI: 10.1016/j.coms.2013.07.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Lee T, Sawhney R, Ducic Y. Miniplate Fixation of Fractures of the Symphyseal and Parasymphyseal Regions of the Mandible. JAMA FACIAL PLAST SU 2013; 15:121-5. [DOI: 10.1001/jamafacial.2013.307] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Thomas Lee
- Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas (Drs Lee, Sawhney, and Ducic), and Departments of Otolaryngology–Head and Neck Surgery, University of Florida, Gainesville (Dr Sawhney), and University of Texas Southwestern Medical Center, Dallas (Dr Ducic)
| | - Raja Sawhney
- Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas (Drs Lee, Sawhney, and Ducic), and Departments of Otolaryngology–Head and Neck Surgery, University of Florida, Gainesville (Dr Sawhney), and University of Texas Southwestern Medical Center, Dallas (Dr Ducic)
| | - Yadranko Ducic
- Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas (Drs Lee, Sawhney, and Ducic), and Departments of Otolaryngology–Head and Neck Surgery, University of Florida, Gainesville (Dr Sawhney), and University of Texas Southwestern Medical Center, Dallas (Dr Ducic)
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Atilgan S, Erol B, Yaman F, Yilmaz N, Ucan MC. Mandibular fractures: a comparative analysis between young and adult patients in the southeast region of Turkey. J Appl Oral Sci 2010; 18:17-22. [PMID: 20379677 PMCID: PMC5349041 DOI: 10.1590/s1678-77572010000100005] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2009] [Accepted: 08/11/2009] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE The purpose of this study was to review and compare the differences between mandibular fractures in young and adult patients. MATERIAL AND METHODS Patients treated at the Oral and Maxillofacial Department of Dicle University during a five-year period between 2000 and 2005 were retrospectively evaluated with respect to age groups, gender, etiology, localization and type of fractures, treatment methods and complications. RESULTS 532 patients were included in the study, 370 (70%) males and 162 (30%) females, with a total of 744 mandibular fractures. The mean age of young patients was 10, with a male-female ratio of 2:1. The mean age of adult patients was 28, with a male-female ratio of 3:1. The most common causes of injury were falls (65%) in young patients and traffic accidents (38%) in adults. The most common fracture sites were the symphysis (35%) and condyle (36%) in young patients, and the symphysis in adults (36%). Mandibular fractures were generally treated by arch bar and maxillomandibular fixation in both young (67%) and adult (39%) patients, and 43% of the adult patients were treated by open reduction and internal fixation. CONCLUSION There was a similar gender, monthly and type of treatment distribution in both young and adult patients in the southeast region of Turkey. However, there were differences regarding age, etiology and fracture site. These findings between young and adult patients are broadly similar to those from other studies. Analysis of small differences may be an important factor in assessing educational and socioeconomic environments.
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Affiliation(s)
- Serhat Atilgan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Dicle University, Diyarbakir, Turkey.
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Behandlung von Unterkieferfrakturen im Kindesalter. Monatsschr Kinderheilkd 2009. [DOI: 10.1007/s00112-008-1876-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Seemann R, Schicho K, Reichwein A, Eisenmenger G, Ewers R, Wagner A. Clinical evaluation of mechanically optimized plates for the treatment of condylar process fractures. ACTA ACUST UNITED AC 2007; 104:e1-4. [PMID: 17942332 DOI: 10.1016/j.tripleo.2007.07.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2007] [Revised: 06/08/2007] [Accepted: 07/09/2007] [Indexed: 10/22/2022]
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Chou JC. Poster 268: Iatrogenic Lateral Displacement of the Mandibular Condyle After Open Reduction of Symphyseal and Parasympyseal Fractures. J Oral Maxillofac Surg 2007. [DOI: 10.1016/j.joms.2007.06.537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Montovani JC, de Campos LMP, Gomes MA, de Moraes VRS, Ferreira FD, Nogueira EA. Etiology and incidence facial fractures in children and adults. Braz J Otorhinolaryngol 2007; 72:235-41. [PMID: 16951858 PMCID: PMC9445666 DOI: 10.1016/s1808-8694(15)30061-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2005] [Accepted: 02/20/2006] [Indexed: 11/25/2022] Open
Abstract
Facial trauma has presented an increasing occurrence in the last four decades, due especially to the growth of accidents with automobiles as well as to the urban violence. Both of which continue being the main cause of such traumas. Aim: To evaluate the features of the population victim of facial trauma as to gender, age, occupation, origin, type of fracture and its cause. Design study: retrospective clinical with transversal cohort. Material and Method: Retrospective study consulting hospital registers of 513 patients victms of the facial trauma. Results: There was a higher incidence of facial trauma on men (84,9%), white (82,7) and with an average age of 29. Regarding occupation, the trauma was mostly occurred to students (16,6%) and Masons (11,2%). The jaw was the most affected place (35%), followed by zygoma (24%) and by the nose (23%), though most patients presented a single facial fracture (82,5%). Among the causes, accidents with automobiles (28,3%), aggressions (21%) and accidental fall s (19,5%) were the most common. Conclusions: Accidents with automobiles continue being the main cause of facial trauma, especially of multiple factures due to the great transmission of kinetic energy.
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Zachariades N, Mezitis M, Mourouzis C, Papadakis D, Spanou A. Fractures of the mandibular condyle: A review of 466 cases. Literature review, reflections on treatment and proposals. J Craniomaxillofac Surg 2006; 34:421-32. [PMID: 17055280 DOI: 10.1016/j.jcms.2006.07.854] [Citation(s) in RCA: 221] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2004] [Accepted: 07/11/2006] [Indexed: 10/24/2022] Open
Abstract
INTRODUCTION The incidence of condylar fractures is high. Condylar fractures can be extracapsular (condylar neck or subcondylar) or intracapsular, undisplaced, deviated, displaced or dislocated. Treatment depends on the age of the patient, the co-existence of other mandibular or maxillary fractures, whether the condylar fracture is unilateral or bilateral, the level and displacement of the fracture, the state of dentition and the dental occlusion, and the surgeon's experience. PURPOSE This report presents the experience acquired in the treatment of 466 condylar fractures over 7 years, reviews the pertinent literature and proposes guidelines for treatment. MATERIAL AND METHODS The archives of KAT, General District Hospital between 1995 and 2002 were scrutinized and the condylar fractures were recorded. The aetiology, age, sex, level of fracture, degree of displacement, associated facial fractures, malocclusion, and type of treatment were noted. RESULTS Four hundred and sixty-six condylar fractures were admitted, the male:female ratio was 3.5:1. Road traffic accidents were the main cause and most fractures were unilateral, displaced, subcondylar, occurred on the left side and were treated conservatively. CONCLUSIONS Early mobilization is the key in treating condylar fractures. Whilst rigid internal fixation provides stabilization and allows early mobilization, conservative treatment is the treatment of choice for the majority of fractures. Children and intracapsular fractures are treated conservatively with or without maxillo-mandibular fixation. Open reduction is recommended in selected cases to restore the occlusion, in severely displaced and dislocated fractures, in cases of loss of ramus height, and in edentulous patients. It may be considered in those with 'medical problems' where intermaxillary fixation is not recommended.
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Affiliation(s)
- Nicholas Zachariades
- Oral and Maxillofacial Department, KAT (Trauma Rehabilitation Center), General District Hospital of Attica, Kifissia, Athens, Greece.
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Montovani JC, Campos LMPD, Gomes MA, Moraes VRSD, Ferreira FD, Nogueira EA. Etiologia e incidência das fraturas faciais em adultos e crianças: experiência em 513 casos. ACTA ACUST UNITED AC 2006. [DOI: 10.1590/s0034-72992006000200014] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
O trauma facial apresenta incidência crescente nas últimas quatro décadas, principalmente devido ao aumento dos acidentes automobilísticos e da violência urbana, que continuam sendo as principais causas desses traumatismos em indivíduos jovens. OBJETIVO: Estudar as características da população vítima de trauma facial através das variáveis sexo, idade, profissão, tipo de fratura e suas causas. FORMA DE ESTUDO: clínico retrospectivo com coorte transversal. MAETERIAL E MÉTODO: Estudo retrospectivo por consulta a prontuários de 513 pacientes vítimas de trauma facial. RESULTADOS: Houve maior incidência de trauma de face em homens (84,9%), brancos (82,7%) e com idade média de 29 anos. Quanto à profissão, estudantes (16,6%) e pedreiros (11,2%) foram os mais acometidos. A mandíbula foi o local mais afetado (35%), seguido do zigoma (24%) e do nariz (23%), sendo que a maioria dos pacientes tinha fratura única de face (81,5%). Dentre as causas, destacaram-se os acidentes automobilísticos (28,3%), agressões (21%) e as quedas acidentais (19,5%). CONCLUSÕES: Os acidentes automobilísticos continuam sendo a principal causa de trauma de face, principalmente de fraturas múltiplas devido à grande transmissão de energia cinética.
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Patrocínio LG, Patrocínio JA, Borba BHC, Bonatti BDS, Pinto LF, Vieira JV, Costa JMC. Fratura de mandíbula: análise de 293 pacientes tratados no Hospital de Clínicas da Universidade Federal de Uberlândia. ACTA ACUST UNITED AC 2005. [DOI: 10.1590/s0034-72992005000500003] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A fratura de mandíbula ocupa o segundo lugar entre as fraturas dos ossos da face, tendo havido aumento significativo de casos nos últimos anos. A não-identificação e o tratamento inadequado podem levar à deformidade estética ou funcional permanente. OBJETIVO: Avaliar os casos submetidos à redução de fratura de mandíbula no Hospital de Clínicas da Universidade Federal de Uberlândia, entre janeiro de 1974 e dezembro de 2002. FORMA DE ESTUDO: coorte historica. PACIENTES E MÉTODO: Duzentos e noventa e três pacientes foram submetidos à redução de fratura de mandíbula e retrospectivamente foram avaliados segundo fatores relacionados a: paciente, trauma, quadro clínico e tratamento cirúrgico. RESULTADOS: Houve uma clara tendência de aumento do número de fraturas de mandíbula ao longo dos anos. Houve um predomínio no sexo masculino (4:1), com pico de ocorrência entre 20 a 29 anos. As principais causas de fratura da mandíbula neste estudo foram acidentes de trânsito e violência, perfazendo juntas 72,4%. Cento e trinta e cinco pacientes apresentavam fratura única. Os sítios mais acometidos foram, em ordem decrescente, sínfise, côndilo, ângulo, corpo, ramo e processo coronóide. Foram realizadas redução incruenta (28), cruenta (213) e associação das duas (11 pacientes), sendo que 56,8% dos pacientes foram tratados nos primeiros 3 dias e 50,4% recebeu a alta hospitalar até o primeiro pós-operatório. Cerca de 10% dos pacientes apresentaram complicações, sendo osteomielite a mais freqüente. CONCLUSÃO: A incidência de fraturas de mandíbula foi marcadamente maior no sexo masculino, durante a terceira década de vida. A causa mais comum foi o acidente de trânsito e as regiões mais atingidas foram sínfise e côndilo. As fraturas isoladas de mandíbula ocorreram em mais de metade dos casos. A maioria dos pacientes foi tratada nos primeiros três dias e recebeu alta até o primeiro pós-operatório. A redução cruenta foi tratamento mais comumente empregado. A complicação mais freqüente foi a osteomielite.
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Patrocínio LG, Patrocínio JA, Borba BHC, Bonatti BDS, Pinto LF, Vieira JV, Costa JMC. Mandibular fracture: analysis of 293 patients treated in the Hospital of Clinics, Federal University of Uberlândia. Braz J Otorhinolaryngol 2005; 71:560-5. [PMID: 16612514 PMCID: PMC9441990 DOI: 10.1016/s1808-8694(15)31257-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Mandibular fracture is the second most common facial fracture and there has been a significant increase in number of cases in the last years. Misidentification and inadequate treatment can take to permanent aesthetic or functional deformity. Aim: Evaluate cases of mandibular fracture reduction in the Hospital of Clinics of the Federal University of Uberlândia, from January of 1974 to December of 2002. Study design: historical cohort. Patient and Method: Two hundred and ninety-three cases of reduction of mandibular fractures were retrospectively analyzed according to factors related to: patient, trauma, signs and symptoms, and surgical treatment. Results: There has been a clear tendency of increase of the number of mandibular fractures along the years. There was higher prevalence in male (4:1), with occurrence peak between 20 to 29 years old. The principal causes of fracture in this study were traffic accidents and violence, representing 72.4%. One hundred and thirty-five patients presented only one fracture. The most injured sites were, in decreasing order, symphysis, condyle, angle, body, ramus, and coronoid. We performed closed reduction (28), open reduction (213) and association of the two (11 patients); 56.8% of the patients were treated within the first 3 days; and, 50.4% were discharged from the hospital until the first postoperative day. About 10% of the patients presented complications, being osteomyelitis the most frequent one. Conclusion: The incidence of mandibular fractures was remarkably larger in the male sex, during the third decade of life. The most common cause was traffic accident, and symphysis and condyle were the most injured sites. Isolated fractures occurred in over half of the cases. Most of the patients were treated in the first three days and were discharged until the first postoperative visit. Closed reduction was the treatment most commonly employed. The most frequent complication was osteomyelitis.
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Affiliation(s)
- Lucas Gomes Patrocínio
- Service of Otorhinolaryngology, Federal University of Uberlândia, Uberlândia, Minas Gerais.
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Ferreira PC, Amarante JM, Silva AC, Pereira JM, Cardoso MA, Rodrigues JM. Etiology and Patterns of Pediatric Mandibular Fractures in Portugal: A Retrospective Study of 10 Years. J Craniofac Surg 2004; 15:384-91. [PMID: 15111795 DOI: 10.1097/00001665-200405000-00008] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE To determine the pattern of occurrence of mandibular fractures in the pediatric population in Portugal. MATERIALS AND METHODS This retrospective study reviews the records of patients 18 years of age or younger from the 10-year period 1993 to 2002. Age, gender, anatomic site, cause of the accident, weekly and monthly variation, location and type of fractures, presence and location of associated injuries, treatment methods, and complications were reviewed. RESULTS During this 10-year period, 521 patients with 681 mandibular fractures were treated. Motor-vehicle accident (MVA) was the most common (53.9% patients) cause of fracture. Almost half of the patients (48.8%) were in the oldest age group (16 to 18 years old). The condyle of the mandible was involved in 31.0% of the fractures. Maxillomandibular (MMF) fixation was used in 534 (78.4%) fractures. Overall mortality in this series was 0.6% (3 patients); mortality was caused by multiple traumas, mainly head trauma. CONCLUSION There is a need to reinforce legislation aimed to prevent MVA and the total enforcement of existing laws to reduce maxillofacial injuries among children and adolescents.
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Affiliation(s)
- Pedro Costa Ferreira
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital de São João, Porto Medical School, Porto, Portugal.
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22
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Abstract
A retrospective study on facial fractures was carried out in the Department of Oral and Maxillofacial Surgery at Tawam Hospital (Al Ain, United Arab Emirates) between January 1, 1998 and December 31, 2001. The study included 144 patients with a mean age of 26.5 years; the most frequently injured patients belonged to the 16- to 20-year-old age group. The male predilection was 83%. Road traffic accident was the most common causative factor (59%), followed by falls (21.5%), accidents where camels were involved (5.5%), work- and sport-related accidents (4.8% and 4.8%, respectively), and assault (4.1%). A total of 53.4% of the patients suffered isolated mandibular fractures, 32.6% had isolated midface fractures, and 13.8% had combined midface and mandibular fractures. Associated injuries were noted in 22.2% of the patients. The number of patients treated increased from 28.3 (1990-1995) to 36 (1998-2001) on an annual average; a reduction in isolated nasal fractures and associated injuries, including facial lacerations, was noted with no change in age or etiology predilection. Sufficient data could not be obtained to determine if the favorable results with the associated injuries were a result of the effect of a compulsory seat belt law introduced on June 1, 1998, but the increasing number of maxillofacial injuries suggests that the seat belt law is ignored in this country.
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Affiliation(s)
- Gusztav Klenk
- Department of Maxillofacial Surgery, Tawam Hospital, Al Ain, United Arab Emirates.
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Fontecha BJ, Fernández M, Reig LR, Sánchez-Ferrín P, Leist A. Bilateral otorrhagia due to a casual fall. J Am Geriatr Soc 2002; 50:1314-5. [PMID: 12133038 DOI: 10.1046/j.1532-5415.2002.50330.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
BACKGROUND No previous studies on mandibular fracture patterns in Tasmania, and very few elsewhere in Australia, have undertaken to discover which identified age, gender, aetiology, anatomical location of the fracture, period of injury, whether alcohol consumption was associated with the injury, and treatment of mandibular fractures. METHOD A retrospective study was undertaken of 251 patients with fractured mandibles presenting to the Royal Hobart Hospital, Tasmania from 1993-1999. Data were obtained from the Oral and Maxillofacial Surgery unit fracture record books cross-checked with patients, impatient/outpatient hospital records. RESULTS The male to female ratio was 4.5:1, with mandibular fractures most common in the male age group of 21-30 years. Assaults (55 per cent of all patients) were the major cause of fractures. Males accounted for 85.5 per cent of assaults, with punching being the most common method, followed by motor vehicle accidents (MVA), 18.3 per cent and sport, 16.7 per cent. In sport, Australian Rules Football was the most common cause, accounting for 45.2 per cent of sporting injuries. The site most frequently fractured was the angle of the mandible. Alcohol abuse was seen in 41.4 per cent of the patients with 84.6 per cent being male. Open reduction and internal fixation with miniplate osteosynthesis, was the preferred treatment modality. The results are compared with other series. CONCLUSIONS Mandibular fractures are common in Tasmania, with the highest rates involved in assaults and sport (especially Australian Rules Football) and a low rate in MVA. These fractures commonly occurred in young males in which assaults, alcohol and social issues were associated. Therefore, preventive measures and strong public awareness addressing this group may be of benefit in reducing the rate of assaults and sporting injuries to the mandible.
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Affiliation(s)
- P Dongas
- Oral and Maxillofacial Surgery Unit, Royal Hobart Hospital, The University of Tasmania
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Hächl O, Tuli T, Schwabegger A, Gassner R. Maxillofacial trauma due to work-related accidents. Int J Oral Maxillofac Surg 2002; 31:90-3. [PMID: 11936407 DOI: 10.1054/ijom.2001.0166] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Even though numerous reports on maxillofacial trauma exist, only a few give detailed information about work-related maxillofacial injuries. The purpose of this study was to reveal the significance of maxillofacial injuries related to accidents occurring at work by evaluating a large number of patients with maxillofacial injuries over a 9-year period. Out of the 8704 trauma patients treated between 1991 and 1999 in the Department of Oral and Maxillofacial Surgery at the University of Innsbruck, Austria, 463 (5.4%) were injured at work. All charts were reviewed and analyzed according to age, gender, cause of accident, occupation, type of injury, location and frequency of fractures. The highest incidence of maxillofacial injury was found among construction workers (a total of 124 patients, 26.8%), followed by craftsmen (102 patients, 22.0%) and office employees (69 patients, 14.9%). The sex distribution showed an overall male-to-female ratio of 11.8:1 and those in the age group most affected were between 20 and 29 years of age. The most frequent cause of injury was a blow in 48.4%, followed by falls and falls over obstacles, accounting for 27.9% and 7.1%, respectively. Of all trauma, 45.4% (210 persons) sustained 423 maxillofacial fractures, 31.7% (147 patients) suffered 232 dento-alveolar injuries, and 21.2% (98 people) showed 430 soft-tissue injuries. One-fifth (20.7%) of all patients displayed concomitant injuries with cerebral and cranial trauma being the most common. The probability of sustaining maxillofacial trauma at work is correlated to the nature of the occupation. Individuals (mostly men) using tools or machines at work are exposed to a much higher risk of work-related maxillofacial trauma.
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Affiliation(s)
- O Hächl
- Department of Oral and Maxillofacial Surgery, University of Innsbruck, Austria
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Marker P, Nielsen A, Bastian HL. Fractures of the mandibular condyle. Part 1: patterns of distribution of types and causes of fractures in 348 patients. Br J Oral Maxillofac Surg 2000; 38:417-21. [PMID: 11010766 DOI: 10.1054/bjom.2000.0317] [Citation(s) in RCA: 69] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This prospective study was designed to record relevant characteristics of mandibular condyle fractures and to evaluate the relationship between these. Data were recorded on sex, age, cause of trauma, level of fracture, dislocation of the mandibular head, dental state and associated fractures of all patients diagnosed in our hospital during the period 1984-1996 with mandibular condyle fractures. Data were analysed in our Computer Department. The sample comprised 348 patients with 444 fractures, and a male:female ratio of 2:1. Traffic accidents were the most common cause: 103 (41%) of the unilateral and 54 (56%) of the bilateral fractures, followed by alleged assault and falls. Low fractures were the most common -n = 314 of 444 (71%). The causes that involved considerable force (traffic accidents and falls) resulted in more dislocations of the mandibular head, more bilateral fractures, a tendency to fractures higher on the condyle and significantly more intracapsular fractures. Absence of molar occlusion also gave more high and fewer low fractures, but played no part in dislocation of the mandibular head from the glenoid fossa.
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Affiliation(s)
- P Marker
- Department of Oral and Maxillofacial Surgery, Odense University Hospital, Odense, Denmark
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Umstadt HE, Ellers M, Müller HH, Austermann KH. Functional reconstruction of the TM joint in cases of severely displaced fractures and fracture dislocation. J Craniomaxillofac Surg 2000; 28:97-105. [PMID: 10958422 DOI: 10.1054/jcms.2000.0123] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
In a clinical and axiographic study the outcome of patients with severely displaced fractures and fracture dislocations of the mandibular condyle was evaluated. Two operation methods were compared one via an intraoral approach without joint revision and another via a preauricular approach with open reduction of the joint. In the group with joint revision, resorbable material was used for osteosynthesis. Twenty-eight patients (32 joints) treated without revision of the joint and 26 patients (29 joints) with open reduction of the joint were evaluated. The mean observation time following surgery was 3 years and 10 months (range 1-7.5 years). Clinical examination utilized the Helkimo-index, while the electronic axiographical results were evaluated by using a five point scheme of joint-mobility. Concerning clinical evaluation, 20 out of 28 patients (71%) without joint revision and 23 out of 26 (89%) patients with joint revision had none or only slight dysfunction of the stomatognathic system. When focusing on arthralgia and pain in motion (part D and E of Helkimo's-index) significantly better results were achieved by open joint revision (Helkimo D: p< or =0.007; Helkimo E: p = 0.0029). No patient exhibited severe dysfunction (group D3). In axiographic evaluation optimal results (group A1) were achieved in seven joints (24%) with revision and four joints (12%) without revision. Twelve out of 29 joints with revision (41%) and six out of 32 joints without revision (19%) were classified as group A2 with a slightly shortened condylar excursion. Revision of joints with disc reduction and reconstruction of ligaments in cases of severely displaced or dislocated fractures resulted in better mobility and less pain. This was seen clinically and in the axiographic results. Looking at the long-term outcome of patients better mobility of the joint without internal derangement due to surgical repair also protects the contralateral (nonoperated) joint. When managing severe TMJ-trauma we suggest that both, bony and soft tissue structures should be reconstructed if there are any signs of internal derangement. However, the limits between bony reconstruction with or without joint revision are still not defined. Our results appear to be promising concerning mobility and absence of pain of the joints after open reduction. Further research comparing the two operative treatment regimes in a randomized controlled clinical trial will be necessary.
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Affiliation(s)
- H E Umstadt
- Department of Oral- and Maxillofacial Surgery, Philipps-Universität, Marburg, Germany.
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Silvennoinen U, Iizuka T, Lindqvist C, Oikarinen K. Different patterns of condylar fractures: an analysis of 382 patients in a 3-year period. J Oral Maxillofac Surg 1992; 50:1032-7. [PMID: 1527654 DOI: 10.1016/0278-2391(92)90484-h] [Citation(s) in RCA: 130] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Three hundred eighty-two patients with 443 condylar fractures, accounting for 52.4% of all mandibular fractures, were given diagnoses and treated in our department between 1987 and 1989. A high proportion of the fractures (44%) were caused by interpersonal violence, followed in incidence by falls (29%) and road traffic accidents (21%). The type of condylar fracture seems to be influenced directly by its cause. Severe fractures in which the condyle was dislocated out of the glenoid fossa resulted more often from falls (22%) and road traffic accidents (26%) than from violence (8%). Fractures caused by violence showed a uniform type characterized by a subcondylar location and nondisplacement or deviation at the fracture line. A relatively large number of patients (56, 15%) were considered to have an indication for open reduction of the fracture.
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Affiliation(s)
- U Silvennoinen
- Department of Oral and Maxillofacial Surgery, Helsinki University Central Hospital, Finland
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Calloway DM, Anton MA, Jacobs JS. Changing Concepts And Controversies In The Management Of Mandibular Fractures. Clin Plast Surg 1992. [DOI: 10.1016/s0094-1298(20)30896-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Iizuka T, Randell T, Güven O, Lindquist C. Maxillofacial fractures related to work accidents. J Craniomaxillofac Surg 1990; 18:255-9. [PMID: 2212023 DOI: 10.1016/s1010-5182(05)80426-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Work-related maxillofacial fractures were studied retrospectively over a six-year period. There were 98 cases accounting for 4.5% of all facial bone fractures treated in our hospital between 1981 and 1986. Of the patients, 89.8% were male. The mean age of the injured was 36.4 years. The incidence of work-related maxillofacial fractures was 0.37 per 1000 workers. Most of the injuries (66%) occurred in factories and construction work. Such work was associated with an to 15 times higher risk of maxillofacial fracture than service and office work. Of the fractures, 20.4% were sustained on the way to or coming from work. At the place of work, the commonest causes of injury were blows from objects or falls from a height (70%). On the way to or coming from work, the aetiological factor was most often a traffic accident. Assault and battery had caused facial bone fractures in 11.2% of cases. Fifty-five patients with midface and 45 patients with mandibular fractures were found, of these, 8 patients had bimaxillary fractures. In 6 cases, only dentoalveolar fractures were found. Of the patients, 55.1% were treated operatively. Sixty-six patients were hospitalized, the mean length of hospital stay being 3.2 days (range 1-12 days).
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Affiliation(s)
- T Iizuka
- Dept. of Oral and Maxillofacial Surgery, Surgical Hospital, Helsinki University Central Hospital, Finland
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Larsen OD, Nielsen A. Mandibular fractures. II. A follow-up study of 229 patients. SCANDINAVIAN JOURNAL OF PLASTIC AND RECONSTRUCTIVE SURGERY 1976; 10:219-26. [PMID: 45484 DOI: 10.3109/02844317609012972] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
During the period 1964-73, 286 patients were treated for mandibular fractures. 229 patients (80%) attended the follow-up examination. The length of observation was from 1 to 9 years. The treatment and the follow-up evaluations in the 229 patients are described. Early fracture treatment has been the objective, also in patients who have undergone severe cerebral traumas. Antibiotic prophylaxis was implemented in cases of compound fractures. Preservation of teeth and tooth buds in the line of fracture was attempted. Clinical infection occurred in 0.4% of the patients. At the follow-up examination 1 patient presented with a fracture displacement outside the condylar process. Neither malocclusion nor pseudarthrosis following fracture or after treatment were seen. Permanent sensory disturbances in the innervation area of the mental nerve following fracture occurred in 8%. Radiological examination of the teeth in the line of fracture revealed unnoticed apical bone lesions in 17% of 118 patients. In a further 23% there was a negative response to the vitality test. Follow-up control of mandibular fractures is advised at 12 to 18 months after treatment.
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