Pathological Fractures of the Mandible: A Report of 27 Cases

Yi Zhao, Rui-Fang Li, Yan-Fang Sun, Bing Liu1, and Jun Jia

State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, China
Department of Prosthodontics, School and Hospital of Stomatology, Wuhan University, China
Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, China

^*Correspondance to: Jun Jia 

 PDF  Full Text DOI: 10.25107/2474-1647.1839

Abstract

Purpose: To review 27 cases of pathological fractures of the mandible.Methods: A retrospective study was undertaken to analyze the etiology, site, treatment methods, and prognosis of pathological mandibular fractures (from 1993 to 2015) at Hospital of Stomatology, Wuhan University.Results: Pathological mandibular fractures were most associated with iatrogenic factor (11 cases), such as rim mandibulectomy, cyst enucleation or third molar extraction, followed by osteoradionecrosis of mandibles (7 cases), bone destruction resulting from benign or malignant tumors (5 cases) and osteomyelitis (4 cases). The predominant site was the mandibular body (23 fractures, 82.14%), followed by the angle/posterior molar region (4 fractures, 14.29%), and one condyle (3.57%). Several methods were used to treat the fractured mandibles. Fourteen cases (51.85%) of pathological fractures were treated by resection, in which seven cases were reconstructed by autogenous bone or composite tissue flap, two with reconstruction plate, and five without reconstruction; six cases of fractures (22.22%) underwent close reduction with intermaxillary fixation or chin cap immobilization; four cases (14.82%) underwent open reduction and internal fixation (wire or miniplate) with/without intermaxillary fixation; and the remaining three cases (11.11% ) treated by sequestrectomy or condylectomy.Conclusion: Pathological mandibular fractures have diverse etiologies. Many patients required resection of primary lesions, while conservative management without rigid fixation can obtain bony union in some patients.

Keywords

Pathological fracture; Mandible; Osteomyelitis; Osteoradionecrosis

Cite the article

Zhao Y, Li R-F, Sun Y-F, Liu B, Jia J. Pathological Fractures of the Mandible: A Report of 27 Cases. Clin Surg. 2017; 2: 1839.