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Retreatment of Mandibular Fractures: A 7-year Retrospective Study of 34 Cases

Charles E. Anyanechi, Birch D. Saheeb

Background: Complications can occur after treatment of mandibular fracture that may require a new surgical treatment; only few studies have evaluated retreatment. Objective: To evaluate the characteristics and the types of treatment done in patients requiring retreatment of mandibular fractures. Materials and Methods: A seven-year retrospective study was done at the Dental and Maxillofacial Surgery Clinic of the study institution. Patients’ data were collected from the hospital records and entered into a pro-forma questionnaire. Results: Overall, 1,373 patients with 1,589 fractures were evaluated, and 39/1589 fractures (2.5%) were retreated due to non- union (n=35, 2.2%) and mal-union (n=4, 0.3%). There were 30 (88.2%) males and 4 (11.8%) females with male to female ratio of 7.5:1. The age of the patients ranged from 26 to 57 years with a mean age of 41.3 ± 4.3 years. Majority (n=27/34, 79.3%) of the patients were in the 4th and 5th decades of life (p=0.001). The premature disruption of inter-maxillary fixation (IMF) after treatment was the most common (n=21/34, 61.8%) associated factor (p= 0.001). The mal-union (n=4, 0.3%) were retreated by re-fracture, nonunion involving the mandibular angle (n= 7, 0.4%) by debridement with removal of bone sequestration and trans-osseous wiring while other nonunion (n=28, 1.8%) by debridement with removal of bone sequestration; and all the patients were thereafter placed on IMF. Conclusion: This study showed that the fractures that required retreatment were due to non-union and mal-union.