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e patterns of facial trauma in different countries. The patient group analyzed in this current study however, shows some interesting features. The most obvious of these is the high proportion (72.5%) of mandibular fractures that were caused by assault, which is one of the highest figures so far reported. The number of patients considered alcohol abusers (44%) and those consuming alcohol prior to being injured (58%) were also markedly high. This gives further evidence to the relationship between alcohol and interpersonal violence. The large proportion of smokers in this study may also be a reflection of the social behavior of this group. The high percentage of unemployed patients (36%) was also significant, contributing to the evidence of a link between unemployment (or increased leisure time) and violence. The profile presented by the patients in this study epitomizes what one would expect in hospitals located within an inner city area of a large, modem city. In such an area there is a concentration of licensed premises and entertainment venues, with minimal opportunity for high-speed motor vehicle accidents.

Fig.3 Time elapsed between the injury and the operation

Fig.4
The advantages of plating techniques for the treatment of mandibular fractures, over more traditional methods, have been highlighted by a number of authors. These include the rapid return to normal masticatory function and mouth opening, resulting in left disturbance to body weight and less time lost from employments. In addition, early mobilization has been recognised as a significant advantage when concurrent condylar fractures are present. Direct visualisation also allows for a more precise anatomical reduction, with the fragments subsequently held in a more stable position by the plategs. This stability is of particular advantage for edentulous mandibles and in angle fractures distal to the last teeth where the masticatory muscles tend to cause displacement. For comminuted fractures longer plates can be used to span all fragments, thus completely stabilizing the area of feature.

Fig.5 Period of hospitalisation in days.
Plates have greatly reduced the need for post-operative intermaxillary fixation, as indicated by 89% of patients in this study not requiring this additional fixation. Intermaxillary fixation is associated with a number of problems, the most important being the restricted access to the airway in unconscious patients. It is also unsuitable for epileptics, alcohol and drug abusers, patients with chronic obstructive airway disease, those unable to attend for regular review, pregnant women and patients whose health would be adversely affected by the decreased nutrition associated with a liquid diets. Intermaxillary fixation frequently requires adjustment or replacement of wires, which suggests the stability of the fixation may be compromised as well as requiring an increased number of outpatient visits. Periodontal problems and residual trismus may also be undesirable sequelae.
It has been suggested that the use of metal plates for mandibular fractures increases the incidence of infections. Conversely, a number of studies have shown low rates of infection associated with the use of miniplate osteosynthesis. Alcoholics have been shown to have an increased incidence of post-operative infections and delayed healing following facial fractured. In this study, however, there were no case