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Unifocal versus multifocal mandibular fractures and injury location

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Abstract

Mandibular fractures are frequently encountered in the trauma setting and comprise a significant number of facial injuries. The purpose of this study was to evaluate the prevalence and injury patterns of unifocal and multifocal mandibular fractures using thin-section imaging. Following IRB approval, 220 patients with mandibular fractures identified on maxillofacial CT scans performed between October 2008 and February 2011 were retrospectively reviewed. Examinations were performed on 64-multidetector row CT scanners with axial images acquired at 1.25-mm slice thickness. The location and number of fractures as well as causative mechanisms were recorded. Fractures were unifocal in 108/220 (49 %) and multifocal in 112/220 (51 %) patients. The mandibular angle was the most common fracture site in both unifocal and multifocal mandible fractures. In cases with multifocal mandibular fractures, bilateral fractures were more common (83 %) than unilateral multifocal mandibular fractures (17 %). Fractures involving the parasymphysis, the mandibular body, or ramus were significantly associated with the presence of additional mandibular fractures (p < 0.0001). While multifocal and unifocal fractures occurred in near equal frequency, bilateral multifocal fractures were much more common than unilateral multifocal mandibular fractures. Alveolar ridge fractures were exclusively seen in unifocal mandibular fractures.

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References

  1. Gassner R, Tuli T, Hächl O, Rudisch A, Ulmer H (2003) Craniomaxillofacial trauma: a 10 year review of 9,543 cases with 21,067 injuries. J Craniomaxillofac Surg 31:51–61

    Article  PubMed  Google Scholar 

  2. King RE, Scianna JM, Petruzzelli GJ (2004) Mandible fracture patterns: a suburban trauma center experience. Am J Otolaryngol 25:301–307

    Article  PubMed  Google Scholar 

  3. Roth FS, Kokoska MS, Awwad EE, Martin DS, Olson GT, Hollier LH, Hollenbeak CS (2005) The identification of mandible fractures by helical computed tomography and panorex tomography. J Craniofac Surg 16:394–399

    Article  PubMed  Google Scholar 

  4. Halazonetis JA (1968) The ‘weak’ regions of the mandible. Br J Oral Surg 6:37–48

    Article  CAS  PubMed  Google Scholar 

  5. Rajput D, Bariar LM (2013) Study of maxillofacial trauma, its aetiology, distribution, spectrum, and management. J Indian Med Assoc 111:18–20

    PubMed  Google Scholar 

  6. Escott EJ, Branstetter BF (2008) Incidence and characterization of unifocal mandible fractures on CT. AJNR Am J Neuroradiol 29:890–894

    Article  CAS  PubMed  Google Scholar 

  7. Abdullah WA, Al-Mutairi K, Al-Ali Y, Al-Soghier A, Al-Shnwani A (2013) Patterns and etiology of maxillofacial fractures in Riyadh City, Saudi Arabia. Saudi Dent J 25:33–38

    Article  PubMed  PubMed Central  Google Scholar 

  8. Hagan EH, Huelke DF (1961) An analysis of 319 case reports of mandibular fractures. J Oral Surg Anesth Hosp Dent Serv 19:93–104

    CAS  PubMed  Google Scholar 

  9. Ogundare BO, Bonnick A, Bayley N (2003) Pattern of mandibular fractures in an urban major trauma center. J Oral Maxillofac Surg 61:713–718

    Article  PubMed  Google Scholar 

  10. Goodday RH (2013) Management of fractures of the mandibular body and symphysis. Oral Maxillofac Surg Clin North Am 25:601–616

    Article  PubMed  Google Scholar 

  11. Chrcanovic BR, Freire-Maia B, Souza LN, Araújo VO, Abreu MH (2004) Facial fractures: a 1 year retrospective study in a hospital in Belo Horizonte. Braz Oral Res 18:322–328

    Article  PubMed  Google Scholar 

  12. Rashid A, Eyeson J, Haider D, van Gijn D, Fan K (2013) Incidence and patterns of mandibular fractures during a 5-year period in a London teaching hospital. Br J Oral Maxillofac Surg 51:794–798

    Article  PubMed  Google Scholar 

  13. Natu SS, Pradhan H, Gupta H, Alam S, Gupta S, Pradhan R, Mohammad S, Kohli M, Sinha VP, Shankar R, Agarwal A (2012) An epidemiological study on pattern and incidence of mandibular fractures. Plast Surg Int 2012:834364

    PubMed  PubMed Central  Google Scholar 

  14. Boole JR, Holtel M, Amoroso P, Yore M (2001) 5196 mandible fractures among 4381 active duty army soldiers, 1980 to 1998. Laryngoscope 111:1691–1696

    Article  CAS  PubMed  Google Scholar 

  15. Carlin CB, Ruff G, Mansfeld CP, Clinton MS (1998) Facial fractures and related injuries: a ten year retrospective analysis. J Craniomaxillofac Trauma 4:44–48

    CAS  PubMed  Google Scholar 

  16. Fridrich KL, Pena-Velasco G, Olson RA (1992) Changing trends with mandibular fractures: a review of 1,067 cases. J Oral Maxillofac Surg 50:586–589

    Article  CAS  PubMed  Google Scholar 

  17. Olson RA, Fonseca RJ, Zeitler DL, Osbon DB (1982) Fractures of the mandible: a review of 580 cases. J Oral Maxillofac Surg 40:23–28

    Article  CAS  PubMed  Google Scholar 

  18. Scherer M, Sullivan WG, Smith DJ Jr, Phillips LG, Robson MC (1989) An analysis of 1,423 facial fractures in 788 patients at an urban trauma center. J Trauma 29:388–390

    Article  CAS  PubMed  Google Scholar 

  19. Haug RH, Prather J, Indresano AT (1990) An epidemiologic survey of facial fractures and concomitant injuries. J Oral Maxillofac Surg 48:926–932

    Article  CAS  PubMed  Google Scholar 

  20. Braasch DC, Abubaker AO (2013) Management of mandibular angle fracture. Oral Maxillofac Surg Clin North Am 25:591–600

    Article  PubMed  Google Scholar 

  21. Shen L, Li J, Li P, Long J, Tian W, Tang W (2013) Mandibular coronoid fractures: treatment options. Int J Oral Maxillofac Surg 42:721–726

    Article  CAS  PubMed  Google Scholar 

  22. Kisnisci R (2013) Management of fractures of the condyle, condylar neck, and coronoid process. Oral Maxillofac Surg Clin North Am 25:573–590

    Article  PubMed  Google Scholar 

  23. Agnihotri A, Prabhu S, Thomas S (2014) A comparative analysis of the efficacy of cortical screws as lag screws and miniplates for internal fixation of mandibular symphyseal region fractures: a randomized prospective study. Int J Oral Maxillofac Surg 43:22–28

    Article  CAS  PubMed  Google Scholar 

  24. Dingman RO, Natvig P (1964) Surgery of facial fractures. WB Saunders, Philadelphia, pp 142–145

    Google Scholar 

  25. Sinn CA, Hill SC, Watson SW (1987) Mandibular fractures. In: Foster CA, Sherman JE (eds) Surgery of facial bone fractures. Churchill Livingstone, New York, pp 177–178

    Google Scholar 

  26. Greene D, Raven R, Carvalho G, Maas CS (1997) Epidemiology of facial injury in blunt assault. Determinants of incidence and outcome in 802 patients. Arch Otolaryngol Head Neck Surg 123:923–928

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Boston Medical Center, Boston University School of Medicine, FGH Building, 3rd Floor, 820 Harrison Avenue, Boston, MA, 02118, USA

    Karen Buch, Adham Mottalib, Rohini N. Nadgir, Akifumi Fujita, Kotaro Sekiya & Osamu Sakai

  2. Center for Patient Safety and Quality Research, Children’s Hospital Boston, Boston, MA, USA

    Al Ozonoff

  3. Department of Otolaryngology—Head and Neck Surgery, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA

    Osamu Sakai

  4. Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA

    Osamu Sakai

Authors
  1. Karen Buch
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  2. Adham Mottalib
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  3. Rohini N. Nadgir
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  4. Akifumi Fujita
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  5. Kotaro Sekiya
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  6. Al Ozonoff
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  7. Osamu Sakai
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Corresponding author

Correspondence to Osamu Sakai.

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This study was approved by the institutional review board.

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The authors declare that they have no conflict of interest.

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Buch, K., Mottalib, A., Nadgir, R.N. et al. Unifocal versus multifocal mandibular fractures and injury location. Emerg Radiol 23, 161–167 (2016). https://doi.org/10.1007/s10140-015-1375-9

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  • DOI: https://doi.org/10.1007/s10140-015-1375-9

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