Evidence-Based Medicine

Morrow, Brad T.; Samson, Thomas D.; Schubert, Warren; Mackay, Donald R.

doi:10.1097/prs.0000000000000717

Cited by 29 publications

(13 citation statements)

References 41 publications

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“…We strongly believe that continuous and shared data collection on epidemiology of traumas in general, is important as social survey of a country and provides useful information to the legislator to intervene on risky behavior to reduce its impact on the population, as we sow in the case of road trauma. 38 Therefore, further prospective studies are needed to update knowledge on the epidemiology of mandibular fractures. Moreover, a regular data analysis could be helpful to establish social support preventive programs, particularly among disadvantaged people who are victims of violence and crime.…”

Section: Discussionmentioning

confidence: 99%

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Mandibular Fractures Epidemiology and Treatment Plans in the Center of Italy: A Retrospective Study

Gualtieri

Pisapia

Fadda

et al. 2020

Journal of Craniofacial Surgery

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However, its use in an environment without aquatic resistance can cause severe damage. 3 Because of the unusual and unpredictable mechanism of injury, the surgical procedure and specialist teams required to remove a harpoon will depend on the affected structures. 1,2 Harpoon removal from craniofacial structures requires a meticulous approach to avoid damage to noble structures, since it has barb on the spear, with the potential to generate resistance to surgical removal. [1][2][3] If the barb is immobile, it is extremely difficult to remove it without surgical approach. 3 Closed mobile barbs into the tissue may be opened during vigorous attempts to remove them. 3,4 In the present case, the harpoon was very close to the left internal carotid, thus the approach to the brain, as well as the careful manipulation of the artefact was critical to avoid further injury. The knowledge of the shaft type and anatomy is essential. 4 Furthermore, the trajectory is different between accident and suicide attempt. 4,5 Owing to the seriousness of the case, a multispecialty approach was vital, including postsurgical support from the neurosurgery, maxillofacial, ophthalmology, and psychology teams which the patient's physical and mental health.

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Section: Discussionmentioning

confidence: 99%

“…It also comes into a hand postoperatively to assist fixation 20,32–34 . Erich arch bar wires are the most used devices for IMF, 37,38 despite their proven disadvantages. Their usage is burdened by possible periodontal and/or teeth damage, increase in operating time and poor oral hygiene 20,34–37 .…”

Section: Discussionmentioning

confidence: 99%

Mandibular Fractures Epidemiology and Treatment Plans in the Center of Italy: A Retrospective Study

Gualtieri

Pisapia

Fadda

et al. 2020

Journal of Craniofacial Surgery

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“…73,88,119,168 Orthopantomograms (i.e., Panorex) are not mandatory, but can be useful in the assessment of dental trauma. 169 With regard to antibiotic administration, level 2 recommendations exist to recommend perioperative antibiotic dosing for fracture repair 170 ; however, there is insufficient evidence for prophylactic antibiotic administration to patients with facial fractures. 171 Many providers do recommend prophylactic antibiotics for open mandible fractures involving tooth-bearing segments; however, there is no evidence to support the use of one antibiotic over another.…”

Section: Imaging and Antibioticsmentioning

confidence: 99%

Interfacility Transfer Guidelines for Isolated Facial Trauma: A Multi-disciplinary Expert Consensus.

Pontell

Steinberg

Mackay

et al. 2022

Plastic &Amp; Reconstructive Surgery

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Background: The objective of this study was to develop guidelines for the transfer of patients with isolated craniomaxillofacial trauma. Methods: A national, multidisciplinary expert panel was assembled from leadership in national organizations and contributors to published literature on facial reconstruction. The final panel consisted of five plastic surgeons, four otolaryngologist–head and neck surgeons, and four oral and maxillofacial surgeons. The expert panelists’ opinions on transfer guidelines were collected using the modified Delphi process. Consensus was predefined as 90 percent or greater agreement per statement. Results: After four Delphi consensus building rounds, 13 transfer guidelines were established, including statements on fractures of the frontal sinus, orbit, midface, and mandible, as well as soft-tissue injuries. Twelve guidelines reached consensus. Conclusions: The decision to transfer a patient with craniomaxillofacial trauma to another facility is complex and multifactorial. While a percentage of overtriage is acceptable to promote safe disposition of trauma patients, unnecessarily high rates of secondary overtriage divert emergency medical services, increase costs, delay care, overload tertiary trauma centers, and result in tertiary hospital staff providing primary emergency coverage for referring hospitals. These craniomaxillofacial transfer guidelines were designed to serve as a tool to improve and streamline the care of facial trauma patients. Such efforts may decrease the additional health care expenditures associated with secondary overtriage while decompressing emergency medical systems and tertiary emergency departments.

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“…1,4 In select cases, namely nondisplaced fractures without evidence of malocclusion or fracture mobility, conservative management with a soft diet may be sufficient. 1,5 Historically, open reduction and internal fixation (ORIF) for traumatic mandibular fractures has been achieved through the use of metallic plates, namely titanium. Metallic implants carry the benefit of providing the necessary tensile strength to withstand forces of mastication while limiting fracture mobility.…”

Section: Introductionmentioning

confidence: 99%

Resorbable Implants for Mandibular Fracture Fixation: A Systematic Review and Meta-Analysis

Chocron

Azzi

Cugno

2019

Plastic and Reconstructive Surgery - Global Open

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Background:Mandibular fractures in adults commonly require rigid fixation to ensure proper occlusion while minimizing infection risks. Numerous centers have assessed the efficacy of resorbable materials as a potential alternative to metallic plates. The purpose of the current systematic review and meta-analysis is to shed light on overall outcomes for resorbable implants and to compare these results to those for metallic counterparts.Methods:A systematic review of clinical studies reporting outcomes for resorbable plates for mandible fractures was carried out. The reported outcomes were hardware failure/exposure, infection, wound dehiscence, reoperation, malocclusion, and nonunion. The results were pooled descriptively and stratified according to fracture and implant type. A subset meta-analysis of prospective studies comparing metallic and resorbable implants was also carried out.Results:Eighteen studies were included for a total of 455 patients managed with resorbable implants (mean follow-up, 8.95 months) with an overall complication rate of 19.8 % (n = 90/455). Infection (n = 31/455, 6.8%) and wound dehiscence (n = 28/455, 6.2%) were the most common complications. Nonunion occurred in 1.1% (n = 5/455) of patients. Seven studies were included in a meta-analysis, and the rates of adverse events in the resorbable and metallic groups were 18.0% (n = 32/178) and 18.3% (n = 33/180), respectively, with no statistically significant difference between both cohorts (95% CI 0.58, 1.82, P = 0.93).Conclusions:This study suggests that there are no statistical differences in outcomes for patients with mandible fractures managed with resorbable or metallic implants. In the absence of meta-analyses or large randomized controlled trials, the current study provides surgeons with an evidence-based reference to guide decision-making.

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Evidence-Based Medicine

Cited by 29 publications

References 41 publications

Mandibular Fractures Epidemiology and Treatment Plans in the Center of Italy: A Retrospective Study

Mandibular Fractures Epidemiology and Treatment Plans in the Center of Italy: A Retrospective Study

Interfacility Transfer Guidelines for Isolated Facial Trauma: A Multi-disciplinary Expert Consensus.

Resorbable Implants for Mandibular Fracture Fixation: A Systematic Review and Meta-Analysis

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