Mandibular fractures in an American inner city: the Harlem Hospital Center experience.
A retrospective study of 116 patients treated at Harlem Hospital for mandibular fractures between 1984 and 1987 was performed. Men comprised 84% of the population studied. The mechanisms of injury were assault with fists and blunt objects (33%), falls (10%), kicking (3%), penetrating injuries (3%), and vehicular accidents (1%). The body of the mandible (46%) and the angle (22%) were the most common fracture sites. Intermaxillary fixation with arch bars was the most frequent method of treatment (55%), followed by open reduction and internal fixation (33%). The complication rate with open reduction was relatively low (15%) despite the fact that 73% of these patients were heavy drug or alcohol abusers with documented poor oral hygiene. This study further substantiates the findings that in the poor inner cities, blunt trauma from drug-related violence has become the major cause of mandibular fracture. Treatment of these patients should include prophylactic broad-spectrum antibiotics, improved oral hygiene, and supplemental nutrition.
Hall
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SC
Plastic Surgery Section, Harlem Hospital Center, New York, New York 10037.
Ofodile
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FA
D000328:Adult; D000437:Alcoholism / Q000150:complications; D005260:Female; D006761:Hospitals; D006801:Humans; D008297:Male; D008337:Mandibular Fractures / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D009519:New York City / Q000453:epidemiology; D012189:Retrospective Studies; D019966:Substance-Related Disorders / Q000150:complications; D014505:Urban Population; D014949:Wounds, Nonpenetrating / Q000150:complications