The management of fractures of the mandible.

In some countries there is a move away from the traditional use of predominantly closed or semi-closed procedures in the management of facial fractures to widespread use of aggressive surgical techniques. Observations are made on the effect that this trend may have on the trainee Oral Surgeon. An analysis of a series of 156 consecutive cases of mandibular fracture bears out the impression that simple jaw support, when there is patient co-operation, is adequate for the treatment of the majority of mandibular fractures and that when fixation is indicated, the eyelet wiring technique gives excellent results without complicating management. When open operation is indicated, intraosseous wire suture is proposed as a convenient method for first consideration. The necessity to determine accurately the pre-accident occlusion in cases of possible malocclusion is underlined and a plea is made to exercise patience in the management of fractures, particularly when the condylar neck is involved.