OCCS Classification and Treatment Algorithm for Comminuted Mandibular Fractures Based on 109 Patients and 11 Years Experiences: A Retrospective Study

Abstract

Comminuted mandibular fractures (CMFs) pose significant challenges to surgeons for their serious complications and poor outcomes. We aimed at proposing a classification with treatment algorithm of each category for CMFs. Patients with CMFs were retrospectively reviewed and classified into five categories: Type I: relatively good occlusion, no or slightly displaced fragments, no continuity destruction or bone defect; Type II: relatively good occlusion, damaged morphology, low comminution degree but intact continuity without bone defect; Type III: damaged morphology and higher comminution degree with intact continuity and relatively good occlusion; Type IV: high comminution, impaired continuity and poor occlusion without segmental bone defect; Type V: segmental bone defect. Conservative treatment, open reduction and internal fixation or microvascular osteocutaneous free flap transplantation was performed, accordingly. Demographics, perioperative data, complications and reasons for reoperations were recorded. The chi-square test was used for statistical analysis. In total, 109 patients were included in the study. After surgery, in the following group, 5 manifested infections, 1 manifested bone non-union, and 2 experienced reoperations, while in the unfollowing group, 10 manifested infections, 5 manifested bone non-union and 8 experienced reoperations. The OCCS classification and algorithm for CMFs achieve better outcomes and with lower complication rate.

Which of 51 Plate Designs Can Most Stably Fixate the Fragments in a Fracture of the Mandibular Condyle Base?

“…The first to be created were squares, rectangles and deltas. Nowadays, they are treated in a number of surgical ways using a wide collection of dedicated titanium plates [ 26 , 27 , 28 , 29 , 30 , 31 , 32 ]. This plethora of choices raises the question of whether, therefore, each plate is equally suitable for treating fractures of the base of the condylar process.…”