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AJNR - American Journal of Neuroradiology

Published ahead of print on February 13, 2008
doi: 10.3174/ajnr.A0973

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American Journal of Neuroradiology 29:890-894, May 2008
© 2008 American Society of Neuroradiology

HEAD & NECK

Incidence and Characterization of Unifocal Mandible Fractures on CT

E.J. Escott^a and B.F. Branstetter^a,b

^a Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pa
^b Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pa

Please address correspondence to Edward J. Escott, MD, Department of Radiology, UPMC Presbyterian Hospital, 200 Lothrop St, D-132, Pittsburgh, PA 15213; e-mail: edescott{at}yahoo.com or escottej{at}upmc.edu

BACKGROUND AND PURPOSE: Conventional thinking among radiologists is that the mandible acts as a closed "ring" that needs to fracture at 2 points, though the frequency of multiple mandible fractures has been reported to be only as high as 67%. However, many of these studies did not use CT to confirm the presence of suggested fractures and excluded nondisplaced fractures. The purpose of this study was to determine the incidence of unifocal mandibular fractures on the basis of detection with dedicated facial bone CT scans and to characterize these fractures.

MATERIALS AND METHODS: We retrospectively reviewed the imaging reports of patients during a 3-year period to identify those who had mandible fractures documented on dedicated facial bone CT scans. The incidence of unifocal fractures was determined, the unifocal fractures were further subcategorized, and any derangements of the temporomandibular joints were also evaluated.

RESULTS: One hundred two patients met the inclusion criteria. The incidence of unifocal mandible fractures was 42% (43/102). Three unifocal fracture patterns identified were the following: simple fractures (25/42, 58%), comminuted fractures (11/42, 26%), and fractures associated with condylar subluxations (7/42, 16%). Most fractures had none to mild displacement or distraction.

CONCLUSION: Unifocal mandible fractures occur with greater frequency than anticipated by most radiologists. This may be due to the somewhat dynamic nature of the mandibular "ring," which includes the temporomandibular joints, though joint derangements evident on CT occur in the minority of cases.