A Retrospective Study Of 228 Cases Of Mandibular Fracture

Mandible is the only active bone of the human maxillofacial,at the front position of the maxillofacial and the shape is like horseshoe.Although the texture of the mandible is firm,it also has weak anatomical position which can easily lead to fracture by improper external force.Mandibular bone has a unique anatomical structure and physiological characteristics,the location of fracture is related with its stress position and the fracture can cause occlusion disorders,chewing dysfunction and other complications which make the mandibular fracture more specially.Many countries have made different research and analysis on mandibular fracture,however the studies in different regions and times made the different results.The influence factors such as culture,economy,social status and even religion can affect the incidence of mandibular fracture.At present,there was no relative research on the distribution of mandibular fractures which was divided by the age,sex composition and etiology in Chongqing.The purpose of this study is to review and summarize the epidemiological characteristics of patients with mandibular fractures which were treated in the Dental Hospital of Chongqing Medical University in the past five years.The patients' age,sex composition,etiology and distribution were analyzed.The Affiliated Stomatological Hospital of Chongqing Medical University is one of the oral specialist tertiary hospital in Chongqing.The patients with mandibular fractures in this hospital have a certain geographical representation of Chongqing.Therefore,the results can provide a scientific basis for the prevention and treatment of mandibular fractures in this region,and provide the preliminary data for the follow-up epidemiological study of mandibular fractures in Chongqing.Objective:To summarize and discuss the morbidity characteristic,treatment and complications of mandibular fracture.Methods:Two hundred and twenty-eight patients with mandibular fracture were evaluated retrospectively.Their age,gender,occupation,cause of fracture,anatomic site,accompanying trauma,treatment methods and complications were collected and analyzed.All the cases were collected from October 2011 to September 2016 in Stomatological Hospital Affiliated to Chongqing Medical University.Results:1.Among 228 cases of mandibular fracture,the incidence of male was 3.15 times higher than that of female.2.The average age was approximately(35.00±14.61)years.Workers accounted for the highest proportion.3.Road traffic accidents was the most common cause,a total of 93 cases,accounting for 40.79%,followed by falls(20.61%).4.There were 425 fractures among all the cases and occurred most common,in decreasing order,in the symphysis(132 cases,31.06%),condyle(129 cases,30.35%),angle(77 cases,18.12%)and body(74 cases,17.41%).5.Forty-one cases(17.98%)had associated injuries mostly combined midface fractures(36 fractures).6.118 patients had a single mandibular fracture,and in the other 99 cases were multiple mandibular fractures.Mandibular single fracture curative effect is better(P=0.022 5).7.Treatment included open reduction with titanium mini-plates and screws in 208 patients,and intermaxillary fixation in other 9 patients.The remaining 11 patients discharged without treatment.Open surgery curative effect is better(P=0.000).8.In this study,the treatment most commonly used was rigid internal fixation combined with intermaxillary fixation in 192 cases,accounting for 88.48% of all receiving treatment patients,which curative effect is better(P=0.010 2).9.Complications occurred in 13 cases(5.70%),mainly due to nerve injury(11 cases,accounting for 5.07%)followed by infection.Facial nerve injury occurs in condylar fracture,inferior alveolar nerve damage occurs in mandibular Angle and mandibular body fracture(P=0.030 3).Conclusion:1.Mandibular fractures occur most likely in young and middle-aged males in Chongqing area.Most patients occur in summer.2.The most common cause was traffic accident,and mostly occur in workers and farmers.3.Mandibular fractures mostly occur in symphysis and condylar.Associated injuries occur in midface mostly.4.Rigid internal fixation combined with intermaxillary fixation is the most common mode of treatment,with5.Surgery should pay attention to protect the nerves.