Abnormal union of mandibular fractures: a review of 84 cases.
OBJECTIVE
The purpose of this study was to investigate the characteristic and contributory factors of mandibular fractures with abnormal union in China, aiming to produce guidelines to facilitate the management of mandibular fractures so that this complication may be avoided.


METHODS
In this retrospective review, the records of all patients who were identified as having abnormal union of mandibular fracture in a period of 10 years (October 1994 to October 2004) in our hospital were collected and analyzed for the features of the patients' age, gender, trauma type, fracture site, and type of abnormal union. At the same time, the data about treatment methods, antibiotics use, presence of infection, patients' compliance, patients' systemic disease, and personal habits such as alcohol or drug abuse were explored and analyzed to determine the main cause contributing to the development of abnormal union.


RESULTS
Eighty-four patients met the inclusion criteria and were included in this study, and 31 to 40 years and 21 to 30 years were the common age groups. Traffic accidents were responsible for the majority of abnormal unions. A total of 135 abnormal unions were identified within the 84 patients, and 44 patients suffered more than one abnormal union. Inadequate unions were more frequent than malunions within the 135 abnormal unions, and most of the abnormal unions were in the condyle. The main causes contributing to the development of abnormal union included being untreated (n = 36), inexperience of the surgeon (n = 27) or patient's noncompliance (n = 6) during the process of treatment, and infection (n = 5). In our series, no patient with alcohol or drug abuse was observed.


CONCLUSIONS
The characteristic of abnormal union is associated with patient's age and gender, severity and type of original trauma, and fracture site. In a sense, the development of abnormal unions is related to the social, economic, and cultural factors in China. At present the key problem of decreasing and avoiding mandibular abnormal unions in our country is to perform appropriate treatment methods in time. At the same time, it is important to obtain patients' compliance during the process of treatment and actively prevent infection.
Li
Zhi
Z
Department of Oral and Maxillofacial Surgery, College and Hospital of Stomatology, Key Lab for Oral Biomedical Engineering of the Ministry of Eduction, Wuhan University, Wuhan, People's Republic of China.
Zhang
Wei
W
Li
Zu-Bing
ZB
Li
Jin-Rong
JR
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D002681:China; D002983:Clinical Competence; D005260:Female; D005592:Fracture Fixation / Q000009:adverse effects* / Q000379:methods; D017102:Fracture Healing; D017759:Fractures, Malunited / Q000209:etiology*; D005599:Fractures, Ununited / Q000209:etiology*; D006801:Humans; D008297:Male; D008335:Mandibular Condyle / Q000293:injuries; D008337:Mandibular Fractures / Q000503:physiopathology* / Q000628:therapy; D008875:Middle Aged; D010349:Patient Compliance; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012737:Sex Factors