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Background: Alcohol as a cofactor in interpersonal violence (IPV) has been established by studies from a number of countries. This study aimed to determine if alcohol was a cofactor in the incidence or severity of mandible fracture. Methods: A prospective study of mandible fracture patients presenting for oral maxillofacial review over 16 months was completed. Injury severity was assessed utilizing the Mandible Injury Severity Score (MISS). Results: A total of 252 facial trauma cases presented to our tertiary referral centre, 83 with fractures of the mandible. The majority of presentations were secondary to IPV (n = 54, 65.06%), 49 (90.74%) of these cases involved alcohol. Overall, alcohol was involved in 63.85% of cases (n = 53). The relative risk of requiring surgical intervention with alcohol involvement was 2.68 (CI = 1.11-9.47). Alcohol significantly increased facial fracture severity for MISS: alcohol (n = 53) 13.07 ± 5.01, no alcohol (n = 30) 11.03 ± 4.87 (p < 0.05). IPV also increased facial fracture severity for MISS: IPV (n = 54) 13.09 ± 4.90, non-IPV (n = 29) 11.00 ± 4.81 (p < 0.05). The angle of the mandible was most commonly fractured (40.5% of cases). Conclusions: Mandible fracture patients, whose injury is a result of IPV, have more severe fractures and a higher likelihood of requiring surgery if alcohol is involved. This correlates to a higher surgical workload, economic and social burden to the community. Primary alcohol and IPV prevention strategies will play an important role in reducing mandible fracture.

Recent literature from general and orthopaedic surgery as well as anaesthetic viewpoints has identified that operations performed outside normal work hours pose potential risks for both patients and healthcare workers. This is in contrast to the increasing pressure for 24h surgical availability for the public and the desire to reduce waiting times for patients. Further, there is evidence of the effects of fatigue on reducing performance. The authors aim to compare outcomes of maxillofacial trauma surgery performed in and out of normal work hours. Retrospective analysis was carried out on all maxillofacial trauma surgery under general anaesthesia at a tertiary referral hospital over a 14-month period. Outcomes of patient mortality, injury severity, patient demographics and operation duration were analysed with reference to two groups: in-hours (0800-1700 Monday to Friday) and out-of-hours (1700-0800 Monday to Friday as well as all operations performed Saturday and Sunday). 134 patients/procedures met the inclusion criteria, 53 out-of-hours and 81 in-hours. A statistically significant (p=0.05) higher complication rate (13%) was found in the out-of-hours cases compared to the in-hours cases (4%). The potential implications for this result on the need for increased availability of dedicated in-hours maxillofacial trauma operating lists at major hospitals are discussed.

This article determines whether it is possible to decrease the number of review appointments following wisdom teeth removal without detriment to the patient. A prospective single-centre study was undertaken in a general hospital with 130 consecutive patients undergoing the removal of impacted wisdom teeth.

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