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Scientific Oral Presentation

Facial Plastic and Reconstructive Surgery

Mandibular Ballistic Fractures: A Retrospective Analysis and Proposed Management Algorithm

Monday, October 19, 2026
1:12 PM - 1:18 PM PT
Location: 404A

    Presenting Author(s)

  • Travis Jonathan Clarke, MD

    Medical Doctor
    University of Tennessee Health Science Center - Department of Otolaryngology
    Memphis, Tennessee, United States

    • Co-Author(s)

  • Aaron L. Zebolsky, MD

    Resident
    University of Tennessee
    Memphis, Tennessee, United States

  • DW

    David M. Weatherford, MD

    Research Fellow
    University of Tennessee Health Science Center, Tennessee, United States

    • Senior Author(s)

  • Anas A. Eid, MD

    Assistant Professor
    University of Tennessee
    Memphis, Tennessee, United States

Introduction: Gunshot wounds to the mandible result in unique and severe injuries. These injuries can result in significant functional and aesthetic deficits, posing challenges for reconstructive surgeons. This study aims to review current surgical techniques and management strategies employed at a large volume level 1 trauma center.

Methods: We performed a single center retrospective review of 220 patients from 2020-2023 with GSWs to the mandible. Data was collected on patient demographics, injury characteristics, surgical interventions, and outcomes. The data was analyzed to identify trends and key factors influencing treatment decisions.

Results: We developed an algorithm for managing gunshot wounds to the mandible. Fractures occurred in the body (33%), ramus/condyle (27%), parasymphysis (18%), and angle (16%). Treatments included closed reduction (42%), external fixation (26%), and ORIF (8%), varying by location. Soft tissue reconstruction was required in 26% of cases, with complex procedures performed in the operating room.

Conclusions: Our study provides a structured algorithm for the management of gunshot wounds to the mandible, aiming to standardize care and improve patient outcomes. By identifying key factors influencing treatment decisions, we hope to guide clinicians in optimizing both functional and aesthetic results for patients with these complex injuries.