A substance abuser is at increased risk for a mandibular fracture, as well as other forms of trauma. Passeri et al identified factors associated with complications after the injury. The authors are from the University of Texas Southwestern Medical Center in Dallas.


Potential causes for mandibular fracture:

(1) getting into a fight

(2) accidents (vehicular, falling, other)


Types of substance abuse - any combination of:

(1) alcohol abuse

(2) injection drug abuse

(3) noninjection drug abuse


Complications may occur in up to 30% of these patients who have mandibular fractures.


Types of complications that occurred:

(1) infection

(2) nonunion


Risk factors for complications:

(1) poor oral health prior to the injury

(2) poor compliance with medications

(3) poor compliance with mandibular immobilization

(4) poor nutritional status

(5) failure to return for followup care

(6) refusal of treatment

(7) delay in presentation


Additional risk factors:

(8) reinjury

(9) HIV infection


A substance abuser with one or more risk factors may require a different type of management if fracture healing is to be achieved.


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