title: Mandibular fracture patterns consistent with posterior maxillary fractures involving the posterior maxillary sinus, pterygoid plate or both: CT characteristics.
abstract: OBJECTIVE
  The aim of this study was to determine the incidence of posterior maxillary fractures involving the posterior maxillary sinus wall, pterygoid plate or both, unrelated to major midface fractures in patients with mandibular fractures, and to characterize associated fractures.
  
  
  METHODS
  A CT study was performed in patients with mandibular fractures to identify posterior maxillary fractures. Patients aged under 16 years, those with mandibular fractures involving only dentoalveolar components and those with concurrent major midfacial fractures were excluded.
  
  
  RESULTS
  13 (6.7%) of 194 patients with mandibular fractures also had posterior maxillary fractures (case group). The injury pattern correlated with the external force directed to the lateral side of the mandible (p < 0.001), alcohol consumption (p = 0.049), the presence of multifocal fractures (p = 0.002) and the fracture regions in the symphysis/parasymphysis (p = 0.001) and the angle/ramus (p = 0.001). No significant difference between the case and non-case groups was seen for age, sex or cause of trauma. Non-displaced fractures in the ipsilateral posterior mandible occurred with significant frequency (p = 0.001) when the posterior maxillary fractures involved only the sinus.
  
  
  CONCLUSIONS
  Mandibular fractures accompanied by posterior maxillary fractures are not rare. The finding of a unilateral posterior maxillary fracture on CT may aid the efficient radiological examination of the mandible based on possible patterns of associated fractures, as follows: in the ipsilateral posterior region as a direct fracture when the impact is a medially directed force, and in the symphysis/parasymphysis or contralateral condylar neck as an indirect fracture.
authors: Department of Oral and Maxillofacial Surgery, Saiseikai Senri Hospital, Suita, Osaka, Japan.
authors: T
authors: T
authors: Imai
authors: S
authors: S
authors: Sukegawa
authors: T
authors: T
authors: Kanno
authors: G
authors: G
authors: Fujita
authors: N
authors: N
authors: Yamamoto
authors: Y
authors: Y
authors: Furuki
authors: M
authors: M
authors: Michizawa
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000706:statistics & numerical data; D007564:Japan / Q000453:epidemiology; D008297:Male; D008335:Mandibular Condyle / Q000293:injuries; D008337:Mandibular Fractures / Q000145:classification / Q000000981:diagnostic imaging / Q000453:epidemiology*; D008440:Maxillary Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology*; D008443:Maxillary Sinus / Q000293:injuries*; D008875:Middle Aged; D009104:Multiple Trauma / Q000453:epidemiology; D012189:Retrospective Studies; D012887:Skull Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology*; D013100:Sphenoid Bone / Q000293:injuries*; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*
keywords: helical CT; mandibular fractures; maxillary fractures; maxillofacial injuries