Characteristics of mandibular injuries caused by bullets and improvised explosive devices: a comparative study

The purpose of this study was to investigate the difference in mandibular trauma caused by two mechanisms for the delivery of missile injuries: firearms and improvised explosive devices (IEDs). The data investigated included sex, age, mechanism of injury, and other clinical and radiographic manifestations. Seventy consecutive patients, predominantly male, with a mean age of 28.6 ± 14 years (range 2-60 years) were enrolled: 38 patients (54.3%) sustained mandibular fractures caused by bullet injuries and 32 patients (45.7%) had mandibular fractures caused by IED explosion injuries. The study revealed that the differences in most of the investigated variables were not statistically significant; the only significant differences were the incidence of trauma to other body regions and the presence of retained foreign bodies. The effect on the mandible of IED explosion resembles that of bullets. Bullet injuries are associated with a relatively higher number of mandibular sites involved and more bilateral fractures, in addition to more extensive bone loss. IEDs, on the other hand, cause more multisystem injuries and result in more retained foreign bodies.