title: Decade review of mandible fractures and arch bar impact on outcomes of nonsubcondylar fractures.
abstract: OBJECTIVE
  Review trends in mandible fracture management and outcomes in patients treated with and without intraoperative arch bar use.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  All patients with mandible fractures between October 1, 2001, and October 1, 2011, were reviewed. Excluded were those with concomitant midfacial fractures or inadequate follow-up.
  
  
  RESULTS
  Overall, 734 patients sustained 1,312 mandible fractures. Assault was the most common etiology. The parasymphyseal, subcondylar, and angle regions were most likely fractured. In total, 85% of patients underwent open-reduction internal-fixation (ORIF). This overall number had no significant annual deviation. However, use of arch bars to achieve intraoperative maxillomandibular fixation (MMF) with ORIF decreased annually, whereas the use of manual reduction with ORIF increased annually. These trends held statistical significance. Outcomes were reviewed in patients with one or two nonsubcondylar fractures by assessing complications of malocclusion, infection, and malunion. In 228 patients meeting criteria, the incidence of complications was 12.9% in those treated using intraoperative arch bars with ORIF and 12.5% in those using manual reduction with ORIF. When assessing individual complications, there was no statistically significant difference.
  
  
  CONCLUSIONS
  Our data suggest a shifting trend in mandible fracture management. Our techniques for achieving fracture reduction ideal for ORIF favors manual reduction over the use of arch bars in select cases. We found no statistical increase in the incidence of complications when using manual reduction with ORIF in patients with one and two nonsubcondylar fractures. In appropriately selected cases, manual stabilization of fractured segments is an alternative to using arch bars to achieve intraoperative MMF.
  
  
  METHODS
  4. Laryngoscope, 126:596-601, 2016.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Kopp
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Crozier
authors.forename: Parul
authors.initials: P
authors.lastname: Goyal
authors.forename: Robert M
authors.initials: RM
authors.lastname: Kellman
authors.affiliation: Upstate Medical University Department of Otolaryngology and Communication Sciences, Syracuse, New York, U.S.A.
authors.forename: Amar C
authors.initials: AC
authors.lastname: Suryadevara
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D015601:Injury Severity Score; D016268:Internal Fixators; D019248:Jaw Fixation Techniques / Q000295:instrumentation*; D008297:Male; D008337:Mandibular Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D011859:Radiography; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D055815:Young Adult
keywords: Mandible fracture; arch bars; nonsubcondylar fractures; open-reduction internal-fixation