The biophysics of mandibular fractures: an evolution toward understanding.
BACKGROUND
Predicting outcomes based on a variety of fixation techniques remains problematic in the treatment of mandible fractures. There is inherent difficulty in comparing the hundreds of published articles on the subject because of the large number of variables, including injury patterns, assessment techniques, treatment approach, device selection and application, and definition of outcome.


METHODS
The authors review the behavior of the human mandible. Behavior of the intact mandible, multiple fracture scenarios, and small and large (single and multiple) plating applications are reviewed.


RESULTS
Several misconceptions in the literature are clarified. Factors that will resolve the dichotomy between clinical results and current biomechanical theories are presented such that a more logical biomechanical model may be used to approach fixation of the mandibular fracture being treated.


CONCLUSIONS
Current mandibular biomechanics theory must be expanded to reflect the complex nature of the system and to more accurately describe conditions that exist in the physical world. Otherwise, further analysis in advancements in outcome and treatment will be relegated to chance.
Rudderman
Randal H
RH
Alpharetta, Ga.; Cleveland, Ohio; and Toronto, Ontario, Canada From private practice; the Department of Civil Engineering, Case Western Reserve University; and the Craniofacial Center for Care and Research, The Hospital for Sick Children.
Mullen
Robert L
RL
Phillips
John H
JH
D001696:Biomechanical Phenomena; D005592:Fracture Fixation / Q000379:methods; D006801:Humans; D008337:Mandibular Fractures / Q000503:physiopathology* / Q000601:surgery; D008962:Models, Theoretical; D011379:Prognosis; D015599:Trauma Severity Indices