[Mandibular fractures: epidemiology, therapeutic management, and complications in a series of 563 cases]. / Fractures de la mandibule: épidémiologie, prise en charge thérapeutique et complications d'une série de 563 cas.

ABSTRACT

INTRODUCTION: The Paris urban and suburban area (Ile-de-France) has the leading regional population in France. This population has specific characteristics. This study concerns mandibular fractures. MATERIAL AND METHOD: A retrospective epidemiologic, clinical, radiographical and therapeutic analysis is conducted with a series of 563 patients with mandibular fracture treated at the Pitié-Salpêtrière University Hospital, in Paris, from 1998 to 2000. RESULTS: Mandibular fracture was generally observed in young men, 40% of whom had poor oral hygiene. The brawls were the dominant etiology (57%) followed by road accidents (12%). The most frequent unifocal fractures were condylar fractures (32%) and angle fractures (32%). The most frequent bifocal mandibular fracture associated angle and symphysis fractures (32%). Osteosynthesis was performed for 73% of patients, including 30% with associated maxillary locking. Complications occurred in 4.8% of the studied cases. DISCUSSION: Despite the increase in traffic, the incidence of road injuries has declined. The first leading and progressing cause of mandibular fractures is brawls. Surgical treatment generally consists in fixation of the bone fracture. Maxillary locking is still associated in 33% of patients, but with a 50% shorter duration. Complications routinely arise because of poor bad oral hygiene.