eMedicine Specialties > Plastic Surgery > Facial Fractures

Facial Trauma, Mandibular Fractures: Follow-up

Author: Donald R Laub Jr, MS, MD, FACS, Associate Professor, Departments of Surgery and Pediatrics, University of Vermont College of Medicine; Interim Chief of Plastic and Reconstructive Surgery, Fletcher-Allen Health Care
Contributor Information and Disclosures

Updated: Jun 25, 2009

Outcome and Prognosis

  • A higher prognosis is achieved with removal of grossly carious and periodontally involved teeth.
  • Treatment should occur as soon as possible. Prolonged delay in treatment contributes to infection.
  • Immobilization of the fracture segments is perhaps the most important aspect in avoiding delayed union, nonunion, and infection.
  • Little difference seems to exist between the infection rates of intraoral and extraoral open reduction procedures.
  • Alcohol abuse plays a major role in the etiology of mandibular fractures. It results in a higher rate of complications either secondary to noncompliance or as a result of metabolic dysfunction.

Future and Controversies

  • The advent of resorbable plates and screws opens a new arena for the treatment of mandible fractures in the pediatric population.12,69 More controlled prospective studies on the use of resorbable plates are necessary prior to their use for pediatric and adult patients with mandible fractures.
  • Rigid fixation techniques have evolved from larger, thicker plates to smaller, low-profile plates while maintaining adequate fixation.70
  • The use of endoscopic techniques may broaden the indications for open reduction of condylar fractures.71,72,73
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous authors Robert David Nesbit, MD; Adel R Tawfilis, DDS; David W Kim, MD; and Patrick Byrne, MD to the development and writing of this article.



More on Facial Trauma, Mandibular Fractures

Overview: Facial Trauma, Mandibular Fractures
Workup: Facial Trauma, Mandibular Fractures
Treatment: Facial Trauma, Mandibular Fractures
Follow-up: Facial Trauma, Mandibular Fractures
Multimedia: Facial Trauma, Mandibular Fractures
References
Further Reading
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Further Reading

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Keywords

jaw fractures, broken jaw, maxillomandibular fixation, MMF, intermaxillary fixation, IMF, internal fixation, rigid plate fixation, wire fixation, jaw fixation, fractured jaw, mandibular fracture, mandible fracture, mandible surgery, mandible pictures, mandible fracture surgery, mandible fracture treatment, treatment, surgical treatment, jaw surgery, mandible fixation, assault injury, motor vehicle injury

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Contributor Information and Disclosures

Author

Donald R Laub Jr, MS, MD, FACS, Associate Professor, Departments of Surgery and Pediatrics, University of Vermont College of Medicine; Interim Chief of Plastic and Reconstructive Surgery, Fletcher-Allen Health Care
Donald R Laub Jr, MS, MD, FACS is a member of the following medical societies: American Association for Hand Surgery, American Cleft Palate/Craniofacial Association, American College of Surgeons, American Society for Surgery of the Hand, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, AO Foundation, Association for Academic Surgery, International College of Surgeons, Northeastern Society of Plastic Surgeons, and Vermont State Medical Society
Disclosure: Nothing to disclose.

Medical Editor

James F Thornton, MD, Assistant Professor, Department of Plastic and Reconstructive Surgery, University of Texas Southwestern
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Jaime R Garza, MD, DDS, FACS, Consulting Staff, Private Practice
Jaime R Garza, MD, DDS, FACS is a member of the following medical societies: Alpha Omega Alpha, American Academy of Otolaryngology-Head and Neck Surgery, American Cleft Palate/Craniofacial Association, American College of Surgeons, American Medical Association, American Society for Aesthetic Plastic Surgery, American Society of Maxillofacial Surgeons, Texas Medical Association, and Texas Society of Plastic Surgeons
Disclosure: Allergan Honoraria Consulting

CME Editor

Nicolas (Nick) G Slenkovich, MD, Director, Colorado Plastic Surgery Center
Nicolas (Nick) G Slenkovich, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Society of Aesthetic Plastic Surgery, American Society of Plastic Surgeons, and Colorado Medical Society
Disclosure: Nothing to disclose.

Chief Editor

Deepak Narayan, MD, FRCS, Associate Professor of Surgery (Plastic), Yale University School of Medicine; Chief of Plastic Surgery, West Haven Veterans Affairs Medical Center
Deepak Narayan, MD, FRCS is a member of the following medical societies: American Association for the Advancement of Science, American College of Surgeons, American Medical Association, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, Indian Medical Association, Plastic Surgery Research Council, Royal College of Surgeons of Edinburgh, and Royal College of Surgeons of England
Disclosure: Nothing to disclose.

 
 
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