Mandible is the second most common facial fracture. There has been a significant increase in the number of cases in recent years with the advent of fast moving automobiles. Mandibular fractures constitute a substantial proportion of maxillofacial trauma cases in Lucknow. This study was undertaken to study mandibular fractures clinicoradiologically with an aim to calculate incidence and study pattern and the commonest site of fractures in population in and around Lucknow. Patient presenting with history of trauma at various centers of maxillofacial surgery in and around Lucknow were included in this study. Detailed case history was recorded followed by thorough clinical examination, and radiological interpretation was done for establishing the diagnosis and the data obtained was analyzed statistically. Out of 66 patients with mandibular fractures, highest percentage was found in 21–30 years of age with male predominance. Road traffic accidents were the most common cause of fracture with parasymphysis being commonest site. Commonest combination was parasymphysis with subcondyle. There was no gender bias in etiology with number of fracture sites. The incidence and causes of mandibular fracture reflect trauma patterns within the community and can provide a guide to the design of programs geared toward prevention and treatment. 1. Introduction The sheer pace of modern life with high-speed travel as well as an increasingly violent and intolerant society has made facial trauma a form of social disease from which no one is immune. There are changes in patterns of facial injuries, extent, clinical features, and so forth resulting in mild-to-massive disfigurement of maxillofacial skeleton along with functional loss. Besides road traffic accident and violence, direct/indirect trauma may also occur due to sport activities, falls, and firearms. Occasionally, it may also be secondary to certain disease entities like cystic lesion, neoplasms, and metabolic diseases. The fracture is defined as “breach in the continuity of bone” [1]. Facial area is one of the most frequently injured area of the body, accounting for 23–97% of all facial fractures [2]. Mandible is the only mobile bone of facial skeleton and their has been a significant increase in number of cases in recent years. It is embryologically a membrane bone and is more commonly fractured than the other bones of face. Mandibular fractures occur twice as often as midfacial fractures [3]. The energy required to fracture it being of the order of 44.6–74.4？kg/m, which is about the same as the zygoma and about half
References
[1]
G. O. Kruger, Textbook of Oral and Maxillofacial Surgery, Jaypee Brothers, 6th edition, 1990.
[2]
T. J. Edwards, D. J. David, D. A. Simpson, and A. A. Abbott, “Patterns of mandibular fractures in Adelaide, South Australia,” Australian and New Zealand Journal of Surgery, vol. 64, no. 5, pp. 307–311, 1994.
[3]
J. A. Halazonetis, “The “weak” regions of the mandible,” British Journal of Oral Surgery, vol. 6, no. 1, pp. 37–48, 1968.
[4]
J. J. Swearingen, Tolerance of the Human Face to Crash Impact, Office of Aviation Medicine, Federal Aviation Agency, Stillwater, Okla, USA, 1965.
[5]
V. R. Hodgson, “Tolerance of the facial bones to impact,” American Journal of Anatomy, vol. 120, pp. 113–122, 1967.
[6]
A. M. Nahum, “The biomechanics of maxillofacial trauma,” Clinics in Plastic Surgery, vol. 2, no. 1, pp. 59–64, 1975.
[7]
E. A. Luce, T. D. Tubb, and A. M. Moore, “Review of 1,000 major facial fractures and associated injuries,” Plastic and Reconstructive Surgery, vol. 63, no. 1, pp. 26–30, 1979.
[8]
D. F. Huelke, “Location of mandibular fractures related to teeth and edentulous regions,” Journal of Oral Surgery, Anesthesia, and Hospital Dental Service, vol. 22, pp. 396–405, 1964.
[9]
E. G. Hagan and D. F. Huelke, “An analysis of 319 case reports of mandibular fractures,” Journal of Oral Science, vol. 6, pp. 37–104, 1961.
[10]
M. Adi, G. R. Ogden, and D. M. Chisholm, “An analysis of mandibular fractures in Dundee, Scotland (1977 to 1985),” British Journal of Oral and Maxillofacial Surgery, vol. 28, no. 3, pp. 194–199, 1990.
[11]
A. B. Bataineh, “Etiology and incidence of maxillofacial fractures in the north of Jordan,” Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, vol. 86, no. 1, pp. 31–35, 1998.
[12]
P. Dongas and G. M. Hall, “Mandibular fracture patterns in Tasmania, Australia,” Australian Dental Journal, vol. 47, no. 2, pp. 131–137, 2002.
[13]
H. E. A. Ahmed, M. A. Jaber, S. H. Abu Fanas, and M. Karas, “The pattern of maxillofacial fractures in Sharjah, United Arab Emirates: a review of 230 cases,” Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology, vol. 98, no. 2, pp. 166–170, 2004.
[14]
B. F. Brasileiro and L. A. Passeri, “Epidemiological analysis of maxillofacial fractures in Brazil: a 5-year prospective study,” Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology, vol. 102, no. 1, pp. 28–34, 2006.
[15]
A. J. Shapiro, R. M. Johnson, S. F. Miller, and M. C. McCarthy, “Facial fractures in a level I trauma centre: the importance of protective devices and alcohol abuse,” Injury, vol. 32, no. 5, pp. 353–356, 2001.
[16]
B. O. Ogundare, A. Bonnick, and N. Bayley, “Pattern of mandibular fractures in an urban major trauma center,” Journal of Oral and Maxillofacial Surgery, vol. 61, no. 6, pp. 713–718, 2003.
[17]
K. Sakr, I. A. Farag, and I. M. Zeitoun, “Review of 509 mandibular fractures treated at the University Hospital, Alexandria, Egypt,” British Journal of Oral and Maxillofacial Surgery, vol. 44, no. 2, pp. 107–111, 2006.
[18]
A. Shah, A. S. Ali, and S. Abdus, “Pattern and management of mandibular fractures: a study conducted on 264 patients,” Pakistan Oral & Dental Journal, vol. 27, no. 1, pp. 103–106, 2007.
[19]
H. O. Olasoji, A. Tahir, and G. T. Arotiba, “Changing picture of facial fractures in northern Nigeria,” British Journal of Oral and Maxillofacial Surgery, vol. 40, no. 2, pp. 140–143, 2002.
[20]
E. Ellis, K. F. Moos, and A. El Attar, “Ten years of mandibular fractures: an analysis of 2,137 cases,” Oral Surgery Oral Medicine and Oral Pathology, vol. 59, no. 2, pp. 120–129, 1985.
[21]
M. H. K. Motamedi, “An assessment of maxillofacial fractures: a 5-year study of 237 patients,” Journal of Oral and Maxillofacial Surgery, vol. 61, no. 1, pp. 61–64, 2003.
