Identification of mandibular fracture epidemiology in Canada: Enhancing injury prevention and patient evaluation

Abstract

BACKGROUND: Mandibular fractures can lead to significant functional and aesthetic sequelae if treated improperly. They may act as an indicator of concomitant trauma and are very demanding on the public health care system. Thus, knowledge of mandibular fracture epidemiology is critical to effective prevention, as well the establishment of accurate trauma evaluation protocols. OBJECTIVES: To identify the epidemiology of mandibular fractures treated at a level 1 Canadian trauma centre, clarify the pathogenesis of these epidemiological patterns and suggest potential targets for preventive efforts. METHODS: A retrospective review of all mandibular fracture patients presenting to the Montreal General Hospital between 1998 and 2003 was performed. Medical records and digitized radiographic imaging were used to collect patient demographics and injury data. RESULTS: The chart review identified 181 patients with 307 mandibular fractures. Fifty-two per cent of the fractures occurred in individuals 21 to 40 years of age, 78% of patients were male, and there was wide ethnic diversity. Sixty percent of patients had multiple mandibular fractures; 29% were symphyseal/parasymphyseal fractures, 25% were condylar fractures and 23% were angle fractures. Assault was the most common mechanism of injury, with 29% of fractures involving alcohol or illegal drug use. Thirty percent of patients had an associated facial fracture, and more than one-third had another major injury. CONCLUSIONS: The present epidemiological review reveals several potential prevention targets as well as significant trends. Further research into the impact of these preventive measures could more objectively identify their impact on mandibular trauma.

Fractures of the mandible: a 20-year retrospective analysis of 753 patients

“…[16] The primary causative factor of mandibular fractures in developing countries is traffic accidents, [2,3,[5][6][7][8][9] whereas interpersonal violence is the major cause of this trauma in developed countries. [10][11][12][13][14] In the literature, there are some reports from developed countries [4,17] indicating traffic accidents as the most frequent cause of mandibular injury. Poor roads and inadequate enforcement of road safety regulations and speed limits are some of the factors that have accounted for the higher incidence of traffic accidents in developing countries.…”

“…[5] Traffic accidents are the most common cause of mandibular fractures in developing countries, [2,[5][6][7][8][9] as well as in Turkey, [3] whereas interpersonal violence is the major causative factor in developed countries. [10][11][12][13][14] The Department of Plastic and Reconstructive Surgery of Erciyes University Medical Faculty is situated in Central Anatolia, and since 1987, has been the only department responsible for the oral and maxillofacial trauma care of a population of nearly 10 million, in Kayseri and the surrounding area. In this series, it was aimed to retrospectively analyze mandibular fractures of patients (≥17 years) who referred to our department and to compare this data with the literature.…”

Prise en charge des fractures mandibulaires à l’hôpital Saint Luc de Cotonou (Bénin). A propos de 83 cas

“…Répartition selon la thérapeutique utilisée. Ces résultats sont superposables à ceux d'études anté-rieures réalisées aussi bien en Afrique [3,7,9,12,13] qu'au Pakistan [8] ou au Canada [10,11] …”

“…Dans les pays déve-loppés, les violences interpersonnelles représentent la principale cause de fractures mandibulaires (41 à 57 % des cas), les AVP seulement 6 à 28 % des cas [10,11,14].…”

“…Globalement, il y a concordance avec les résultats de travaux antérieurs quant à la localisation parasymphyso-symphysaire du trait de fracture (27 à 55 % des cas selon les études) [8,11,13]. Il existe probablement une corrélation entre cette localisation parasymphyso-symphysaire de la fracture et les AVP où le choc se fait plus volontiers sur le menton selon un impact direct.…”