Risk Factors and Interventional Predictors for Postoperative Malunion and Nonunion in Adult Mandibular Fractures: A Scoping Review.

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Abstract

Conflict of interest statement: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. 4. OTA Int. 2025 Oct 6;8(5 Suppl):e433. doi: 10.1097/OI9.0000000000000433. eCollection 2025 Oct. Emerging basic science concepts in geriatric fracture fixation and patient recovery. Mau M(1), Leucht P(2), Frihagen F(3), Duque G(4), Yoon R(5), Schemitsch E(6), Haller J(1). Author information: (1)Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT. (2)Department of Orthopaedic Surgery, New York University Langone, New York, NY. (3)Orthopedic Department, University of Oslo, Oslo, Norway. (4)Department of Geriatric Medicine, McGill University, Montreal, Canada. (5)Department of Orthopaedic Surgery, Rutgers-RWJBH-Cooperman Barnabas/Jersey City Medical Center, Jersey City, NJ. (6)Department of Surgery, Western University, London, ON, Canada. In recent history, human life expectancy has increased significantly, resulting in a high burden of late-life morbidity and geriatric fractures. Changes to the body as a result of aging, such as degeneration of the bone marrow, osteoblast apoptosis, and a decline in hormone production, coupled with sarcopenia, are only a few factors that predispose the elderly to fractures. In addition, these factors further complicate surgical management, as they increase the risk of fixation failure, nonunion, malunion, and wound complications. As a result, the standards of geriatric fracture fixation must account for variables that are rarely included when planning for surgery in the younger population. Operative fixation should provide a stable limb to allow for early mobilization and weight bearing, lowering the risk of medical complications. Therefore, early mobility is of the utmost importance in the setting of most fragility fractures. However, early mobility in some, such as the pelvic fragility fracture, may lead to an increased risk for bleeding and death. Geriatric fractures carry significant morbidity, mortality, and financial risk, which indicates that there should be a continuing review and understanding of the multifactorial process leading toward and treatment strategies employed after geriatric fractures. The purpose of this review is to summarize the biology of aging, the causes, effects, and treatments of sarcopenia, the current fixation strategies of geriatric fractures, and the importance of mobility in the geriatric patient. Copyright © 2025 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Orthopaedic Trauma Association. DOI: 10.1097/OI9.0000000000000433 PMCID: PMC12494311