Patients With Isolated Mandible Fractures Should Be Screened for Concussion

Patients who present with isolated mandible fractures may benefit from concussion screening, report investigators in a recently published study JAMA Facial Plastic Surgery.

The prospective study was undertaken to test the hypothesis that concussions after mandible fractures are more common than previously thought. The study included 16 patients with a mandible fracture seen within 24 hours of presenting to the emergency department of a level I trauma center between June 2013 and June 2014. Most of the patients were male (88%), and the mean age was 27.5 years.

The cause of fracture was due to assault in 12 (75%) patients, sports injury in 2 (13%), car crash in 1 (6%), and bike injury in 1 (6%). Alcohol use (but no illicit drug use) was reported in 50% of the patients.

To see which patients may be at high risk of developing a concussion, they were given the Military Acute Concussion Evaluation (MACE) test within 24 hours of their injury (mean 11.25 hours, range of 3-21 hours).

Based on MACE, 12 (75%) of patients met the criteria for concussion. Alcohol use at the time of injury was reported by 7 of these 12 (58%) patients.

“These findings of concussion are higher than anticipated,” said Robert M. Kellman, MD, professor and chair in the department of otolaryngology and communication sciences at SUNY Upstate Medical University in Syracuse, N.Y., an author of the study. As such, he emphasized that concussions should be considered in all patients with mandible fractures.