Prevalence and Pattern of Mandibular Fractures: A Retrospective Study in India.

Objective: The main objective of this study is to analyze the prevalence of age, gender distribution, etiology, anatomic distribution, and treatment of mandibular fractures. Materials and
Methods: This 2-year retrospective study was carried out in few multispeciality hospitals in India. The results were collected, and descriptive statistics were analyzed using SPSS.
Results: Of 180 patients that were analyzed, males and the age group of 20-30 years had a higher prevalence of mandibular fractures with road traffic accidents being the most common etiological factor. Condyle was the most common site affected. Open treatment with rigid and nonrigid fixation was the commonly used method of treatment.
Conclusion: Stratification of various epidemiological studies with data obtained over a large study period and sample size must be obtained to understand the plausible factors associated with mandibular fractures for appropriate diagnosis and management of mandibular fractures. Copyright:

INTRODUCTION

Mandible is the most commonly involved site in orofacial trauma and constitutes nearly 10%–40% of it.[12] Fractures involving mandible can occur only at one site or can involve multiple anatomic sites.[3] Etiology of mandibular fractures involves road traffic accidents, sports injuries, and assault.[4] Nearly 50% of mandibular fractures in men arise due to assaults, whereas in women, motor vehicle accidents and falls are most common.[5]

Condyle is the most common site of fracture followed by angle of the mandible.[6] Management of mandibular fractures can include closed reduction and open reduction by nonrigid fixation with wire, rigid internal fixation with plates or lag screws.[7] Postoperative complications are influenced by the site of the fracture and can lead to restricted jaw movement, speech difficulty, and airway restriction.[89] This aim of the article is to analyze the age, gender distribution, etiology, anatomic distribution, and treatment of mandibular fractures.

MATERIALS AND METHODS

The study sample includes 180 patients from the Department of Oral and Maxillofacial Surgery in a multispeciality hospital, Chennai. Age, gender, etiology, site, and treatment of the mandibular fractures were assessed. This study was done retrospectively including the mandibular fracture cases reported between January 2019 and January 2021. The results were collected, and descriptive statistics were analyzed using the Statistical Package for the Social Sciences (SPSS version 21) IBM SPSS Statistics (Chicago, IL).

RESULTS

Age distribution

The age group of the records examined ranged from 20 to 60 years. About 42.4% of the patients were in the age group of 20–30 years, 21.2% in the 31–40 age group, 19.9% in the 41–50 age range, and the remaining 16.5% of the study subjects were above 50 years of age [Figure 1].

Figure 1

Age distribution

Gender distribution

The gender distribution was 61.4% male and 38.6% female [Figure 2].

Figure 2

Gender distribution

Etiology of the mandibular fractures

Road traffic accidents were the major cause of mandibular fractures with a prevalence of 62.8%, followed by sports injuries 18.2%. Mandibular fractures due to assaults comprised 9.8%, 5.5% due to falls, and 3.7% due to extraction of teeth [Figure 3].

Figure 3

Etiology of the mandibular fractures

Site of the mandibular fractures

The majority of the mandibular fractures occurred at the condyle with 34.9%, followed by angle of the mandible with 29.8%. 23.1% of the fractures occurred at body of the mandible, 7.6% at the symphysis, and the 4.6% at parasymphysis [Figure 4].

Figure 4

Site of the mandibular fractures

Management of the mandibular fractures

The majority of the mandibular fractures were treated by open reduction, 64.8%, whereas the rest 35.2% were treated by closed reduction [Figure 5].

Figure 5

Management of the mandibular fractures

DISCUSSION

This retrospective study was done to review the prevalence, age, gender distribution, most common site, etiology, and the treatment of mandibular fractures. In this study, males had a higher prevalence of mandibular fractures compared to women. A significant number of mandibular fractures occurred in the age group of 20–30 years. This could be due to the fact that they are more prone to road traffic accidents, sports injuries, and assaults. The major etiologic factor was road traffic accidents followed by sports injuries and assaults. Falls and fracture due to extraction were also an etiologic factor. The most common location of mandibular fracture in this study was condyle followed by angle of the mandible. Body of the mandible, symphysis, and parasymphysis was also susceptible to fracture. The majority of the cases were treated by open reduction by rigid and nonrigid fixation.

Ellis et al. analyzed 3400 mandibular fractures and found a high male preponderance of mandibular fractures between the age group of 21 and 30 years with the majority of the cases occurring due to road traffic accidents.[10] In accordance with our study and the study by Ellis et al., Barde et al. in 2014 reviewed 464 patients having mandibular fractures and observed that the fractures were predominant in males in the age group of 21–30 years with the main cause being road traffic accidents. However, contradictory to our study, Barde et al. reported parasymphyseal fractures as the most common site.

In accordance with our study, Ghodke et al. reported a majority of the prevalence in male patients with road traffic accidents being the most common etiological factor, condyle as the most commonly affected site, and open reduction and rigid internal fixation as the most commonly used treatment.

The limitations of the study of the study include convenience sampling, and the data for the purpose of the study were collected from respondents in Chennai only.

CONCLUSION

Since the prevalence of mandibular of mandibular fractures and their association with site and etiology can vary with different locations, stratification of data with a larger sample size and various epidemiological must be carried out for better understanding, diagnosis, treatment, and outcomes of mandibular fractures.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.