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Management of Mandible Fractures

  • Facial Trauma (R. Kellman, Section Editor)
  • Published:
Current Otorhinolaryngology Reports Aims and scope Submit manuscript

Abstract

Mandible fractures are common injuries and vast amounts of scientific literature are dedicated to defining and refining the principles and techniques that guide their repair. The purpose of this article is to review, evaluate, and summarize the most notable and recent contributions to this body of literature. Several recent articles demonstrate that mandible fractures occur primarily in young men and are most commonly sustained through low-velocity blunt force trauma. Open management of condylar and subcondylar fractures is being widely advocated as yielding better long-term functional results with acceptable surgical morbidity. As open reduction and internal fixation of most subsite fractures gains traction, the use of post-operative maxilla–mandibular fixation is being used less commonly in favor of early mobilization. Finally, absorbable plates may yield equivalent functional outcomes without interfering with the growth of the mandible in pediatric patients. These articles summarize the current opinion regarding the management of mandibular fractures. Articles describing the epidemiology of these fractures and recent technical advances are summarized.

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References

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  1. Kim K, Ibrahim A, Koolen PG, Lee BT, Lin SJ. Trends in facial fracture treatment using the American College of Surgeons National Surgical Quality Improvement Program database. Plast Reconstr Surg. 2014;133:627–38.

    Article  CAS  PubMed  Google Scholar 

  2. Pena I Jr, Roberts LE, Guy WM, Zevallos JP. The cost and inpatient burden of treating mandible fractures: a nationwide inpatient sample database analysis. Otolaryngol Head Neck Surg. 2014;151(4):591–8.

    Article  PubMed  Google Scholar 

  3. •• 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. doi:10.1016/j.joms.2015.04.032. Largest recent multi-institutional series describing the epidemiology of mandibular fractures.

  4. Morris C, Bebeau NP, Brockhoff H, Tandon R, Tiwana P. Mandibular fractures: an analysis of the epidemiology and patterns of injury in 4,143 fractures. J Oral Maxillofac Surg. 2015;73(5):951.

    Article  PubMed  Google Scholar 

  5. Gutta R, Tracy K, Johnson C, James LE, Krishnan DG, Marciani RD. Outcomes of mandible fracture treatment at an academic tertiary hospital: a 5-year analysis. J Oral Maxillofac Surg. 2014;72(3):550–8.

    Article  PubMed  Google Scholar 

  6. Swanson EW, Susarla SM, Ghasemzadeh A, Mundinger GS, Redett RJ, Tufaro AP, Manson PN, Dorafshar AH. Application of the mandible injury severity score to pediatric mandibular fractures. J Oral Maxillofac Surg. 2015;12:S0278–2391.

    Google Scholar 

  7. Hoppe IC, Kordahi AM, Paik AM, Lee ES, Granick MS. Age and sex-related differences in 431 pediatric facial fractures at a level 1 trauma center. J Craniomaxillofac Surg. 2014;42(7):1408–11.

    Article  PubMed  Google Scholar 

  8. Siwani R, Tombers NM, Rieck KL, Cofer SA. Comparative analysis of fracture characteristics of the developing mandible: the Mayo Clinic experience. Int J Pediatr Otorhinolaryngol. 2014;78(7):1066–70.

    Article  PubMed  Google Scholar 

  9. Hakim SG, Trankle T, Kimmerle H, Sieg P, Jacobsen HC. A new non-endoscopic intraoral approach for open reduction and internal fixation of subcondylar fractures of the mandible. J Craniomaxillofac Surg. 2014;42(7):1166–70.

    Article  PubMed  Google Scholar 

  10. Liu CK, Jing CX, Li W, Wang J, Zhou H, Hu M, Hu KJ. Observational study of surgical treatment of sagittal fractures of mandibular condyle. J Craniofac Surg. 2015;26(4):e359–64.

    Article  PubMed  Google Scholar 

  11. • Zrounba H, Lutz JC, Zink S, Wilk A. Epidemiology and treatment outcome of surgically treated mandibular condyle fractures. A five years retrospective study. J Craniomaxillofac Surg. 2014;42(6):879–84. Largest recent series describing outcomes following ORIF of condylar and subcondylar fractures.

  12. Dalla Torre D, Burtscher D, Widmann G, Pichler A, Rasse M, Puelacher W. Surgical treatment of mandibular condyle fractures using the retromandibular anterior transparotid approach and a triangular-positioned double miniplate osteosynthesis technique: a clinical and radiological evaluation of 124 fractures. J Craniomaxillofac Surg. 2015;43(6):944–9.

    Article  PubMed  Google Scholar 

  13. Kolk A, Neff A. Long-term results of ORIF of condylar head fractures of the mandible: a prospective 5-year follow-up study of small-fragment positional-screw osteosynthesis (SFPSO). J Craniomaxillofac Surg. 2015;43(4):452–61.

    Article  PubMed  Google Scholar 

  14. Khiabani KS, Raisian S, Mehmandoost MK. Comparison between two techniques for the treatment of mandibular subcondylar fractures: closed treatment technique and transoral endoscopic-assisted open reduction. J Maxillofac Oral Surg. 2015;14(2):363–9.

    Article  PubMed  Google Scholar 

  15. Ho SY, Liao HT, Chen CH, Chen YC, Chen YR, Chen CT. The radiographic and functional outcome of bilateral mandibular condylar head fractures: a comparison between open and closed treatment. Ann Plast Surg. 2015;74(2):S93–8.

    CAS  PubMed  Google Scholar 

  16. Shi D, Patil PM, Gupta R. Facial nerve injuries associated with the retromandibular transparotid approach for reduction and fixation of mandibular condyle fractures. J Craniomaxillofac Surg. 2015;43(3):402–7.

    Article  PubMed  Google Scholar 

  17. Saman M, Kadakia S, Ducic Y. Postoperative maxillomandibular fixation after open reduction of mandible fractures. JAMA Facial Plast Surg. 2014;16(6):410–3.

    Article  PubMed  Google Scholar 

  18. Zhan S, Jiang Y, Cheng Z, Ye J. A meta-analysis comparing the 2.0-mm locking plate system with the 2.0-mm non-locking plate system in treatment of mandible fractures. J Craniofac Surg. 2014;25(6):2094–7.

    PubMed  Google Scholar 

  19. West GH, Griggs JA, Chandran R, Precheur HV, Buchanan W, Caloss R. Treatment outcomes with the use of maxillomandibular fixation screws in the management of mandible fractures. J Oral Maxillofac Surg. 2014;72(1):112–20.

    Article  PubMed  Google Scholar 

  20. Van den Bergh B, Blankestijn J, van der Ploeg T, Tuinzing DB, Forouzanfar T. Conservative treatment of a mandibular condyle fracture: comparing intermaxillary fixation with screws or arch bar. A randomized clinical trial. J Craniomaxillofac Surg. 2015;43(5):671–6.

    Article  PubMed  Google Scholar 

  21. Stanton DC, Liu F, Yu JW, Mistretta MC. Use of bioresorbable plating systems in paediatric mandible fractures. J Craniomaxillofac Surg. 2014;42(7):1305–9.

    Article  PubMed  Google Scholar 

  22. Li Z, David I, Li ZB. The use of resorbable plates in association with dental arch stabilization in the treatment of mandibular fractures in children. J Craniomaxillofac Surg. 2014;42(5):548–51.

    Article  PubMed  Google Scholar 

  23. An J, Jia P, Zhang Y, Gong X, Han X, He Y. Application of biodegradable plates for treating pediatric mandibular fractures. J Craniomaxillofac Surg. 2015;43(4):515–20.

    Article  PubMed  Google Scholar 

  24. • Rha EY, Paik H, Byeon JH. Bioabsorbable plates and screws fixation in mandible fractures: clinical retrospective research during a 10-year period. Ann Plast Surg. 2015;74(4):432–6. Largest recent series describing outcomes following ORIF of mandibular fractures with absorbable plates.

  25. Lim HY, Jung CH, Kim SY, Cho JY, Ryu JY, Kim HM. Comparison of resorbable plates and titanium plates for fixation stability of combined mandibular symphysis and angle fractures. J Korean Assoc Oral Maxillofac Surg. 2014;40(6):285–90.

    Article  PubMed Central  PubMed  Google Scholar 

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Correspondence to Arnaud F. Bewley.

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This article is part of the Topical Collection on Facial Trauma.

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Bewley, A.F., Farwell, D.G. Management of Mandible Fractures. Curr Otorhinolaryngol Rep 3, 209–214 (2015). https://doi.org/10.1007/s40136-015-0095-8

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  • DOI: https://doi.org/10.1007/s40136-015-0095-8

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