PURPOSE: To investigate the occurrence of accelerated bone healing evidenced by early callus formation in patients with mandibular fractures and traumatic brain injury (TBI). MATERIALS AND METHODS: A retrospective cohort study was performed in patients who presented for mandibular fracture evaluation and management over a 6-year period. Subjects eligible for the study included those who underwent a computed tomographic examination of the mandible more than 2 weeks after the injury and had not undergone surgery with rigid internal fixation. TBI was used as the predictor variable. Time to callus formation as detected on computed tomographic scans was recorded as the primary outcome variable. Other variables considered included age, gender, coma duration, and fracture distribution. Appropriate statistical analyses were performed to determine the influencing factors. RESULTS: Forty-five patients with mandibular fractures (24 with severe TBI and 21 without TBI) were retrospectively analyzed. Twelve patients with TBI and 6 without TBI exhibited a visible callus on their computed tomographic scans. Statistical analysis showed no significant differences in age, gender, examination time, and fracture distribution between the groups. Cox proportional hazards regression analysis indicated a positive correlation of time to callus formation with TBI and coma duration but not with age, gender, and fracture distribution. CONCLUSIONS: These findings suggest that patients with severe TBI and mandibular fractures exhibit increased fracture healing as evidenced by early callus formation. A more exhaustive study is required to advance the understanding of this phenomenon and provide additional clinical significance.
PURPOSE: To investigate the occurrence of accelerated bone healing evidenced by early callus formation in patients with mandibular fractures and traumatic brain injury (TBI). MATERIALS AND METHODS: A retrospective cohort study was performed in patients who presented for mandibular fracture evaluation and management over a 6-year period. Subjects eligible for the study included those who underwent a computed tomographic examination of the mandible more than 2 weeks after the injury and had not undergone surgery with rigid internal fixation. TBI was used as the predictor variable. Time to callus formation as detected on computed tomographic scans was recorded as the primary outcome variable. Other variables considered included age, gender, coma duration, and fracture distribution. Appropriate statistical analyses were performed to determine the influencing factors. RESULTS: Forty-five patients with mandibular fractures (24 with severe TBI and 21 without TBI) were retrospectively analyzed. Twelve patients with TBI and 6 without TBI exhibited a visible callus on their computed tomographic scans. Statistical analysis showed no significant differences in age, gender, examination time, and fracture distribution between the groups. Cox proportional hazards regression analysis indicated a positive correlation of time to callus formation with TBI and coma duration but not with age, gender, and fracture distribution. CONCLUSIONS: These findings suggest that patients with severe TBI and mandibular fractures exhibit increased fracture healing as evidenced by early callus formation. A more exhaustive study is required to advance the understanding of this phenomenon and provide additional clinical significance.
Authors: Martijn Hofman; Guido Koopmans; Philipp Kobbe; Martijn Poeze; Hagen Andruszkow; Peter R G Brink; Hans-Christoph Pape Journal: Mediators Inflamm Date: 2015-03-22 Impact factor: 4.711