Pattern of mandibular fractures in an urban major trauma center.
OBJECTIVE
Many studies focusing on the pattern of presentation of mandibular fractures are inconclusive. This is largely due to a multifactorial involvement of associated factors and the role of anatomic factors.


METHODS
We reviewed a 10-year retrospective analysis of the pattern of presentation of mandibular fractures at an urban level I trauma center in Washington, DC, and the significance of the variables in association with the fractures. These include mechanism of action, age group, illicit drug use, seasonal variation, and the incidence of multiple fracture sites. We also looked at the evolving pattern of mandibular fractures in comparison to an earlier study conducted in the 1960s at the same hospital. Data collection was done through the use of medical records and all documented radiographs. Variables that were analyzed in association with the fractures include age, gender, mechanism of action, seasonal variation, and anatomic location. Data analysis was done using subjective analysis, frequency distribution, and multiple regression tests, where appropriate.


RESULTS
Data analysis shows that 86% of all fracture patients are male, and 37% of all patients were in the 25- to 34-year-old age group. Use of an illicit substance at the time of trauma was seen in 55% of all cases. Interpersonal violence accounted for 79% of all patients, with prevalence in the summer (31%) and winter (28%) months. The most common location of fracture is in the angle region (36%), followed by the body (21%) and parasympyhseal region (17%), with 52% presenting with more than one fracture site.


CONCLUSIONS
The evolving pattern of fractures in urban trauma centers is showing an increasing trend of association with illicit substances and interpersonal violence as a major causative factor.
Ogundare
Bolaji O
BO
Department of Oral and Maxillofacial Surgery, Howard University Hospital, Washington, DC, USA. bqo5495@nyu.edu
Bonnick
Andrea
A
Bayley
Neil
N
D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D001741:Black or African American; D017677:Age Distribution; D000368:Aged; D002648:Child; D004219:District of Columbia / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008337:Mandibular Fractures / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology* / Q000473:pathology; D008875:Middle Aged; D012189:Retrospective Studies; D012621:Seasons; D017678:Sex Distribution; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000150:complications; D014504:Urban Health / Q000706:statistics & numerical data; D014754:Violence / Q000706:statistics & numerical data; D014948:Wounds, Gunshot / Q000150:complications