Fracture of the Atrophic Mandible: Case Series and Critical Review

Purpose: Atrophic mandible fracture is common among elderly patients. Such fractures present management difficulties related to anatomic and physiologic alterations in this population. The purpose of this study was to evaluate the results of this type of fracture treatment and to realize a critical review of literature on the subject. Patients and Methods: The sample was obtained from records of patients of Restauracao Hospital (Recife, Brazil) who underwent surgical treatment of atrophic mandible fracture between 2006 and 2009. Data, such as etiology, location, and degree of displacement of the fractures, as well as access, type of fixation used, and the presence of postoperative complications, were analyzed. Results: Successful bone union was achieved in 100% of cases. Complications were related to those patients treated with reconstruction plates (2.4 mm) Conclusions: Open reduction and internal fixation with miniplates seem a feasible option for primary treatment of atrophic mandible fractures without comminution or loss of substance. The level of scientific evidence for the treatment of atrophic mandible fractures is low. (C) 2011 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 69:1430-1435, 2011