Facial Trauma Management During the Coronavirus Disease 2019 Pandemic

Abstract

Importance: Facial trauma is managed with open or closed treatment modalities; however, the impact of the coronavirus disease 2019 (COVID-19) pandemic on facial trauma management remains unclear. Objective: To determine whether the management of facial trauma varied during the COVID-19 pandemic. Design Setting, Participants: A retrospective review of 127 adults at The R Adams Cowley Shock Trauma Center at the University of Maryland between March 2019 and March 2021. Adults were stratified into pre-COVID (before March 2020) and post-COVID groups. Main Outcomes and Measures: Open reduction internal fixation alone, maxillomandibular fixation (MMF) alone, Open reduction internal fixation and MMF, and closed reduction. Results: Of the 127 patients, 66 were treated pre-COVID (52%) and 61 post-COVID (48%). While the prevalence of mandible fractures did not differ (pre-COVID, n = 39, 59%; post-COVID, n = 42, 69%; P = 0.33), the use of MMF alone decreased (pre-COVID, n = 9, 23%; post-COVID, n = 1, 2%; P = 0.005). In contrast, while the prevalence of displaced nasal bone fractures decreased (pre-COVID, n = 21, 32%; post-COVID, n = 4, 7%; P = 0.0007), management with closed reduction did not differ (pre-COVID, n = 23, 96%; post-COVID, n = 11, 85%; P = 0.27). Conclusions and Relevance: Although the clinical characteristics of patients with facial fractures did not differ during the COVID-19 pandemic, the use of MMF for mandible fractures changed significantly. Level of Evidence: Level IV.

Influence of COVID‐19 pandemic on mandible fracture patterns in a German cranio‐maxillofacial trauma center: PreCOVID (2019) versus IntraCOVID (2020)

“…The number of study participants/patients with mandible fractures is of a similar size to comparable studies in cranio-maxillofacial trauma centers. 27,30 Both the age distribution and the female: male ratio in the present study are comparable to the results of similar publications. 27,28 In the present study we saw a sharp decrease in mandible Regarding the fracture location, significant differences were only found for mandible ramus fractures in the present study (PC = 43.1%…”

Changes in Hospital Admissions for Facial Fractures During and After Covid 19 Pandemic: National Multicentric Epidemiological Analysis on 2,938 Patients.

“…For instance, with many recreational facilities and public spaces closed, people may be engaging in different types of activities at home, potentially leading to a shift in the causes of facial fractures. Similarly, the increase in work from home arrangements could potentially lead to a decrease injuries, including facial fractures [17][18][19]. This shift in epidemiology is clearly illustrated in the results of our study.…”

Impact of COVID-19 pandemic on the dynamic of patients with oral and maxillofacial trauma: interrupted time-series analysis

“…Second, closed reduction (including nasal bone reduction) mirrored the dynamics of nasal fractures, with an increase in percentage but undergoing a change in trend as a temporal dynamic. A report from the United States reported that during the COVID-19 pandemic, the clinical characteristics of patients with facial fractures remained unchanged, but the use of mandibulomaxillary fixation (MMF), a conservative treatment for mandibular fractures, decreased significantly 24 . However, the cause of the MMF decrease is considered to differ from the change in the dynamics of closed reduction (including nasal bone reduction) in Japan.…”