Prospective Audit of Mandibular Fractures at the Charlotte Maxeke Johannesburg Academic Hospital (Maxillofacial Surgery) (Report‪)‬

The history of maxillofacial and oral injuries, including mandibular fractures, from 1650 BC to the present, is the topic of two publications. (1,2) To summarise: the Greek 'Father of Medicine' Hippocrates was the first to describe fracture treatment--he recommended bandages and single jaw fixation. Celsus, a Roman (30 BC-50 AD), was one of the earliest physicians to recognise the importance of establishing the occlusion in the treatment of fractures. His principle of fracture immobilisation was the forerunner of intermaxillary fixation (IMF), a system still in use. In 1275, Salicetti of Salerno continued Celsus' IMF principle, combining this with wiring together of teeth adjacent to a fracture (the tension band principle). From the late 18th century, the development and use of extra-oral splints was in favour, combined with closed reduction of fractures. Once anaesthesia was introduced in the mid-19th century, open reduction and immobilisation of fractures improved treatment and was further refined from the 1960s to today. Whatever mandibular fracture management may be used, clinicians and service planners need to understand work loads. For this, a clinical audit (3) is a useful method. The current study was a prospective clinical audit of mandibular fractures in the Division of Maxillofacial and Oral Surgery at Charlotte Maxeke Johannesburg Academic Hospital from 1 March to 31 August 2004, to determine presentation patterns for service planning and comparison with other audits in South Africa and elsewhere.