Pathological fractures of the mandible: A report of ten cases and a review of the literature

Abstract

Introduction: Pathological fractures of the mandible are rare. They account for approximately 2% of all mandibular fractures. The main purpose of the study is to report our experience concerning this condition and to analyse data and review the literature available. Material and methods: This study reviewed retrospectively the records of patients who presented to the department of Plastic and Maxillofacial surgery between 2000 and 2008 with a pathological fracture of the mandible. The collected data included age, sex, mechanism of injury, aetiology, anatomic site of fracture, treatment and complications. Results: There were 10 patients with an average age of 48 years and 10 months. There were three cases of fracture due to a local malignancy, two cases of osteoradionecrosis, two cases of mandibular cysts, one patient presenting a mandibular histiocytosis, one patient with a metastatic carcinoma (Thyroid), and one case related to mandibular atrophy. Most common mechanisms of injury were chewing and falls. Pathological fractures were often located in the body of the mandible. A surgical approach was performed in most cases. Conclusion: Surgical management of pathological fractures of the mandible depends largely on the aetiology. Complications occur more often because of local condition and bad oral hygiene.

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Abir, B. , Guerrouani, A. and Abouchadi, A. (2013) Pathological fractures of the mandible: A report of ten cases and a review of the literature. Open Journal of Stomatology, 3, 419-424. doi: 10.4236/ojst.2013.38070.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Allan, B.P. and Daly, C.G. (1990) Fractures of the mandible: A 35-year retrospective study. International Journal of Oral and Maxillofacial Surgery, 19, 268-271.
http://dx.doi.org/10.1016/S0901-5027(05)80417-5
[2] Gerhards, F., Kuffner, H.D. and Wagner, W. (1998) Pathological fractures of the mandible: A review of the etiology and treatment. International Journal of Oral and Maxillofacial Surgery, 27, 186-190.
http://dx.doi.org/10.1016/S0901-5027(98)80007-6
[3] Coletti, D. and Ord, R.A. (2008) Treatment rationale for pathological fractures of the mandible: A series of 44 fractures. International Journal of Oral and Maxillofacial Surgery, 37, 215-222
http://dx.doi.org/10.1016/j.ijom.2007.09.176
[4] Ezsias, A. and Sugar, A.W. (1994) Pathologic fractures of the mandible: a diagnostic and treatment dilemma. British Journal of Oral and Maxillofacial Surgery, 32, 303-306.
http://dx.doi.org/10.1016/0266-4356(94)90051-5
[5] Cope, M.R. (1982) Spontaneous fracture of an atrophic edentulous mandible treated without fixation. British Journal of Oral and Maxillofacial Surgery, 20, 22-30.
http://dx.doi.org/10.1016/0007-117X(82)90003-8
[6] Marx, R.E. (1983) Osteoradionecrosis: A new concept of its pathophysiology. Journal of Oral and Maxillofacial Surgery, 41, 283-288.
http://dx.doi.org/10.1016/0278-2391(83)90294-X
[7] Epstein, J.B., Wong, F.L.W. and Stevensom-Moore, P. (1987) Osteoradionecrosis: Clinical experience and a proposal for classification. Journal of Oral and Maxillofacial Surgery, 45, 69-71.
http://dx.doi.org/10.1016/0278-2391(87)90399-5
[8] Myers, R.A. and Marx, R.E. (1990) Use of hyperbaric oxygen in postradiation head and neck surgery. NCI Monography, 9, 151-157.
[9] Al Gahtani, M., Alqudah, M., Al Shehri, S., et al. (2009) Pathologic fracture of the mandible caused by metastatic follicular thyroid carcinoma. Journal of the Canadian Dental Association, 75, 457-460.
[10] Marx, R.E. (2003) Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: A growing epidemic. Journal of Oral and Maxillofacial Surgery, 61, 1115-1117.
http://dx.doi.org/10.1016/S0278-2391(03)00720-1
[11] Wang, J., Goodger, N.M. and Pogrel, M.A. (2003) Osteonecrosis of the jaws associated with chemotherapy. Journal of Oral and Maxillofacial Surgery, 61, 1104-1107. http://dx.doi.org/10.1016/S0278-2391(03)00328-8
[12] Migliorati, C.A. (2003) Biphosphonates and oral cavity avascular bone necrosis. Journal of Clinical Oncology, 21, 4253-4254. http://dx.doi.org/10.1200/JCO.2003.99.132
[13] Ruggiero, S., Gralow, J., Marx, R.E., Hoff, A.O., Schubert, M.M., Huryn, J.M., et al. (2006) Practical guidelines for the prevention, diagnosis and treatment of osteonecrosis of the jaw in patients with cancer. Journal of Oncology Practice, 2, 7-14.
http://dx.doi.org/10.1200/JOP.2.1.7
[14] Rattin, C., Vanoli, A. and Latombe, I. (2008) Extensive osteonecrosis of the jaws associated with biphophonates therapy. Annales d’Otolaryngologie et de Chirurgie Cervico-faciale, 125, 24-29.
http://dx.doi.org/10.1016/j.aorl.2007.09.002
[15] Gering. A., Grange, L., Villier, C., Woeller, A. and Mallaret, M. (2007) Biphosphonates-associated osteonecrosis of the jaw: Review on reported cases. Therapie, 62, 49-54.
http://dx.doi.org/10.2515/therapie:2007003
[16] Luhr, H.G., Reidick, T. and Merten, H.A. (1996) Results of treatment of fractures of the atrophic edentulous mandible by compression plating: A retrospective evaluation of 84 consecutive cases. Journal of Oral and Maxillofacial Surgery, 54, 250-254.
http://dx.doi.org/10.1016/S0278-2391(96)90733-8
[17] Pogrel, M.A., Podlesh, S., Anthony, J.P. and Alexander, J. (1997) A comparison of vascularised and nonvascularized bone grafts for reconstruction of mandibular continuity defects. Journal of Oral and Maxillofacial Surgery, 55, 1200-1206.
http://dx.doi.org/10.1016/S0278-2391(97)90165-8
[18] Ioannides, C., Fossion, E., Boecke, W., Hermans, B. and Jacobs, D. (1994) Surgical management of the osteoradionecrotic mandible with free vascularised composite flaps. Journal of Cranio-Maxillofacial Surgery, 22, 330-334.
http://dx.doi.org/10.1016/S1010-5182(05)80113-1
[19] Girod, A., Bouletreau, P., Freidel, M. and Breton, P. (2004) Vascularized osseous flaps for mandibular reconstruction after osteoradionecrosis. Revue de Stomatologie et de Chirurgie Maxillo-Faciale, 105, 255-268.
http://dx.doi.org/10.1016/S0035-1768(04)72324-4

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