A prospective study examining the effects of treatment timing in the management of mandible fractures

The ideal timing for treatment of mandible fractures has not been well established. The objective of this study was to analyse the effects of treatment timing in the surgical management of mandible fractures. A prospective evaluation of 215 continuous patients with a total of 359 mandible fractures...

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Bibliographic Details
Published in:International journal of oral and maxillofacial surgery 2018-09, Vol.47 (9), p.1126-1131
Main Authors: Hurrell, M.J.L., David, M.C., Batstone, M.D.
Format: Article
Language:English
Subjects:
Adult
assault
delay
Dentistry
Female
fracture
Fracture Fixation, Internal - methods
Humans
Incidence
Male
mandible
Mandibular Fractures - surgery
Postoperative Complications - epidemiology
Prospective Studies
surgery
Time-to-Treatment
timing
trauma
Treatment Outcome
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Summary:The ideal timing for treatment of mandible fractures has not been well established. The objective of this study was to analyse the effects of treatment timing in the surgical management of mandible fractures. A prospective evaluation of 215 continuous patients with a total of 359 mandible fractures was undertaken. Nine outcome variables were analysed in relation to treatment delay by logistic regression modelling: wound dehiscence, hardware exposure, local postoperative infection, malocclusion, trismus, nerve damage, fracture non-union, return to theatre, and radiographic outcome. Nineteen additional variables were included in the analysis to adjust for potential confounding. Delay was measured in days and ranged from 0 to 41days, with a mean delay of 4.6days. The incidence of wound dehiscence, hardware exposure, local postoperative infection, trismus, nerve damage, fracture non-union and return to theatre was 6%, 4%, 11%, 8.5%, 47%, 2% and 8%, respectively. Objective malocclusion and poor radiographic outcomes were evident in 13% and 4.5% of cases, respectively. No statistically significant association was found between treatment delay and treatment outcomes. The findings of this study suggest it may be safe to delay the definitive treatment of mandible fractures. Treatment delay may allow for improved resource distribution and prioritization of more time-dependent interventions.
ISSN:0901-5027
1399-0020
DOI:10.1016/j.ijom.2018.03.017