Rajesh Gutta1, Kyle Tracy2, Christopher Johnson2, Laura E James3, Deepak G Krishnan4, Robert D Marciani5. 1. Voluntary Assistant Professor, Division of Oral and Maxillofacial Surgery, University of Cincinnati, Cincinnati, OH; and Private Practice, Mountain State Oral and Maxillofacial Surgeons, Charleston, WV. Electronic address: rajeshg76@yahoo.com. 2. Resident, Division of Oral and Maxillofacial Surgery, University of Cincinnati, Cincinnati, OH. 3. Research Associate, Department of Surgery, University of Cincinnati, Cincinnati, OH. 4. Assistant Professor and Program Director, Division of Oral and Maxillofacial Surgery, University of Cincinnati, Cincinnati, OH. 5. Professor and Chief, Division of Oral and Maxillofacial Surgery, University of Cincinnati, Cincinnati, OH.
Abstract
PURPOSE: To analyze the outcomes of mandible fractures treated using open reduction and internal fixation. PATIENTS AND METHODS: We performed a retrospective chart review of the medical records from patients with mandibular fractures treated surgically during a 5-year period for demographics, systemic illness, history of substance abuse, etiology, fracture location, any associated facial injury, type and timing of repair, antibiotic treatment, and interval to repair. The development of complications such as infection, malunion or nonunion, hardware failure, and wound dehiscence were recorded. RESULTS: Of the 560 patients, adequate data were collected for 363 patients. Of the patients, 60% were white. The male/female ratio was 7.4:1. Systemic illness was noted in 10.5% of the cohort. More than 80% of the subjects had sustained their injury because of assault. The mandible angle was the most common site of fracture (56%). Most (64%) of the patients had sustained multiple fractures. When multiple sites were involved, the angle and body were more commonly involved. The overall complication rate was 26.45%. Hardware failure (15.4%) was the most common complication, followed by infection (15.15%). The revision rate was 8.1% in this cohort. Antibiotic usage and the infection rate were not statistically associated with each other. A greater complication rate was noted among smokers (P = .0072) and patients with systemic illness (P = .0495). CONCLUSIONS: A greater rate of hardware failure was noted in our study. The use of antibiotics did not decrease the incidence of infections. Smokers and patients with systemic medical conditions had a greater risk of complications. Finally, a slight delay in surgical repair was not related to an increased complication rate.
PURPOSE: To analyze the outcomes of mandible fractures treated using open reduction and internal fixation. PATIENTS AND METHODS: We performed a retrospective chart review of the medical records from patients with mandibular fractures treated surgically during a 5-year period for demographics, systemic illness, history of substance abuse, etiology, fracture location, any associated facial injury, type and timing of repair, antibiotic treatment, and interval to repair. The development of complications such as infection, malunion or nonunion, hardware failure, and wound dehiscence were recorded. RESULTS: Of the 560 patients, adequate data were collected for 363 patients. Of the patients, 60% were white. The male/female ratio was 7.4:1. Systemic illness was noted in 10.5% of the cohort. More than 80% of the subjects had sustained their injury because of assault. The mandible angle was the most common site of fracture (56%). Most (64%) of the patients had sustained multiple fractures. When multiple sites were involved, the angle and body were more commonly involved. The overall complication rate was 26.45%. Hardware failure (15.4%) was the most common complication, followed by infection (15.15%). The revision rate was 8.1% in this cohort. Antibiotic usage and the infection rate were not statistically associated with each other. A greater complication rate was noted among smokers (P = .0072) and patients with systemic illness (P = .0495). CONCLUSIONS: A greater rate of hardware failure was noted in our study. The use of antibiotics did not decrease the incidence of infections. Smokers and patients with systemic medical conditions had a greater risk of complications. Finally, a slight delay in surgical repair was not related to an increased complication rate.
Authors: Úrsula M Jariod Ferrer; Sara Blanco Sanfrutos; Marina A Gavin Clavero; Maria Victoria Simon Sanz; Tomas Uson Bouthelier; Bartolomeu Nadal Cristobal Journal: J Maxillofac Oral Surg Date: 2018-08-28
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