Treatment Delay Impact on Open Reduction Internal Fixation of Mandibular Fractures: A Systematic Review

Stone, Nicholas; Corneman, Alex; Sandre, Anthony R.; Farrokhyar, Forough; Thoma, Achilleas; Cooper, Michael

doi:10.1097/gox.0000000000001829

Cited by 25 publications

(27 citation statements)

References 45 publications

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“…It is consensus that MF should be addressed early, in general, treatment is performed as soon as possible, ideally in the first 72 hours after the traumatic event. However, this timing is at the mercy of many variables, such as urgency in addressing other injuries, age, comorbidities, mental disorders, non-cooperative patients, lack of specialized care, delayed communication and transfer between hospital units, and financial situation (Hurrell & Batstone, 2014;Stone et al, 2018;Kraeima et al, 2018;King et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

“…Patients may report pain, functional limitation, dysphagia, occlusal changes and facial deformities, which is why, in most cases, surgical treatment is necessary (Pickrell & Hollier, 2017). Untreated mandibular fractures (MF) may result in trismus, malocclusion, infection and persistent pain; therefore, they must be addressed early to avoid complications, malunion and nonunion of bone fragments (Stone et al, 2018;Reddy et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

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Three-dimensional biomodel in the treatment of bilateral mandibular fracture sequelae: a case report

Oliveira

Santos

et al. 2021

RSD

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Mandibular fractures lead to changes in occlusion, aesthetic deformities and functional alterations, when untreated, their sequelae may cause permanent problems, leading to a more complex treatment than the acute trauma. The treatment offers challenges that can be minimized with the aid of biomodels, printed by 3D technology. This article aims to report a biomodel-assisted surgical procedure for mandibular reconstruction, arguing how these prototypes may help to achieve better outcomes. The patient was involved in an automobile accident and sought treatment for the sequelae of mandibular fractures two years after the initial trauma. The biomodel printing of her mandible allowed for the execution of surgery on the model, reestablishing correct occlusion and facial aesthetics, and helping shorten the surgical time through the pre-bending of reconstruction plates. The patient improved uneventfully. The use of biomodels must be encouraged, especially in cases where the patient shows sequelae, when the anatomical landmarks are compromised, they offer more predictability for treatment outcomes, as described on this case report.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Three-dimensional biomodel in the treatment of bilateral mandibular fracture sequelae: a case report

Oliveira

Santos

et al. 2021

RSD

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“…There is a lack of well-designed prospective studies to reliably determine the importance of treatment delay as an independent predictor of postoperative complications including nonunion. 3 Additionally, because of the possible serious consequences of infection, it has traditionally been routine to administer postoperative antibiotics. However, in recent years, this has also been questioned.…”

Section: Nonunion and Infectionmentioning

confidence: 99%

Secondary Management of Mandible Fractures

et al. 2019

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Mandibular fractures are the most common facial fractures that need surgical intervention. If untreated, these fractures affect a patient's occlusion, degree of mouth opening, and facial symmetry, and could cause infection with significant pain. The goal of any surgical intervention is to restore the preinjury occlusion, even if the preinjury occlusion is abnormal. Initial therapies, whether surgical or conservative, are not always successful, however, and revision or delayed surgical intervention can be challenging. Herein, we review common causes of failure of primary surgical management of mandibular fractures and provide tips to successful secondary intervention.

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“…6), including an orbital systematic review in 2015 and an orbital systematic review and meta-analysis in 2016 (55,78,79,(94)(95)(96)(97)(98). Of note, the 2015 systematic review by Dubois et al(55) included six of the ten case series otherwise identified by this PhD literature review(80,81,84,86,94,97), and the 2016 systematic review and meta-analysis by Daamgard et al(78) identified the review by Dubois et al(55), along with a differing six of ten case series otherwise identified by this PhD literature review (81,84,86,87,95,96).…”

mentioning

confidence: 99%

“….6 Studies identified in 2019 that found a conflicted relationship between treatment delay and treatment outcome.Twenty-seven studies were identified in the literature over the entire review period that analysed outcomes of mandible fracture treatment in isolation with respect to treatment delay. (17, 18, 21, 24, 25, 57-59, 62-65, 68-71, 73-77, 79, 85, 88, 91, 93, 98) Of the twenty-seven, there were twenty-three retrospective case series(17, 18, 24, 57-59, 63-65, 68-71, 73-77, 85, 88, 91, 93, 98), two prospective case series(21,62), and two systematic reviews (25,79). The first systematic review, by Hermund et al in 2008, stated that ''there is presently no strong evidence for either acute or delayed treatment of mandibular fractures in order to minimise healing complications".…”

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confidence: 99%

Treatment timing and patient compliance in the management of facial fractures

Hurrell¹

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Background: Facial fractures are a common presentation to hospitals worldwide. However, many uncertainties remain. The relevance of delay from injury to treatment is commonly disputed amongst surgeons and in the literature. Immediate or very early treatment is suggested by its advocates to improve treatment outcomes and the patient experience. However, there are many reasons why delay may be practical, unavoidable, or even clinically beneficial. Further, the deleterious effects of patient noncompliance, a classic confounding variable in the assessment of treatment delay, are frequently 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. Study 3. Undertaken simultaneously and with the same patient cohort as study 2, a prospective case series analysing the effects of patient demographics on patient compliance. Demographics were measured with the following variables for each patient: age, gender, distance to oral and maxillofacial service, dental status, alcohol use, cigarette use, illicit drug use, employment status, and injury aetiology. Compliance with post-operative instructions was measured with the following variables for each patient: soft diet, mouthwash, oral antibiotics, cigarette cessation, and review appointment attendance. Study 4. Undertaken simultaneously and with the same patient cohort as studies 2 and 3, a prospective case series analysing the effects of patient compliance on outcomes of mandible fracture management. Compliance with post-operative instructions was measured with the following variables for each patient: soft diet, mouthwash, oral antibiotics, cigarette cessation, and review appointment attendance. In addition, a global compliance score was used. Eight outcome variables were analysed in relation to compliance: wound dehiscence, hardware exposure, local post-surgery infection, malocclusion, trismus, nerve damage, fracture non-union, and return to theatre. Results: Study 1. Delay was measured in days and ranged from zero to seventeen days, with a mean delay of 8.6 days. The incidence of unacceptable facial asymmetry, obvious facial scarring, trismus, and poor radiographic outcomes was 3%, 46%, 10% and 9% respectively. Statistically significant associations were found between delay and facial scarring, and delay and radiographic outcome. For each additional delay of a day, the odds of facial scarring being present, compared to absent, decreased by 13%. For regular cigarette users, for each additional day of delay there was a 306-fold increased risk of having a radiographic outcome of major deviation from premorbid compared to equivalent to premorbid. 4 Study 2. Delay was measured in days and ranged from zero to forty-one days, with a mean delay of 4.6 days. The incidence of wound dehiscence, hardware exposure, local post-operative infection, trismus, nerve damage, fracture nonunion and return to theatre was 6%, 4%, 11%, 8.5%, 47%, ...

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Treatment Delay Impact on Open Reduction Internal Fixation of Mandibular Fractures: A Systematic Review

Cited by 25 publications

References 45 publications

Three-dimensional biomodel in the treatment of bilateral mandibular fracture sequelae: a case report

Three-dimensional biomodel in the treatment of bilateral mandibular fracture sequelae: a case report

Secondary Management of Mandible Fractures

Treatment timing and patient compliance in the management of facial fractures

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