CROOMA, complication rates of operatively treated mandibular fractures, paramedian and body

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011 Apr;111(4):449-54. doi: 10.1016/j.tripleo.2010.06.008. Epub 2010 Oct 16.

Abstract

Introduction: This retrospective study comprises an exploratory analysis of 10 years of surgical treatment of symphysis (S) and parasymphysis/body (P/B). Correlations of complications, as well as dependencies of surgical concepts, are investigated.

Materials and methods: All surgically treated patients in the period of 1995 to 2005 with at least one mandibular fracture mesial to the mandibular angle were included in this study. A total of 63 patients (46 men, 17 women) with 63 symphysis fractures were included and 497 patients (369 men, 128 women) with 553 P/B were included; 99.27% (549) of these fractures were included in the study, 4 had to be dismissed because of inconclusive documentation.

Results: Of patients with P/B, 96.04% were successfully treated with 1 open reduction, 3.76% had 2, and 0.20% had 3 surgeries. Of the surgically treated patients, 75.77% (416) were completely free of complications, whereas the other 24.23% of the P/B showed 1 or more complications. The main complication was mild nerve damage (24.8%). Osteosynthesis failure rate (OFR) was 2.4% (7 of 298) for 2 miniplates, 5.7% (3 of 53) for 1 tension screw, and 8.4% (9 of 107) for 1 miniplate. Regarding OFR, 2 miniplates showed to be superior in a Fisher exact test (P = .018, adjusted P = .132). Symphysis fractures were completely free of complications in 81.8% and showed 2 major complications, i.e., 1 severe nerve damage and 1 osteosynthesis failure.

Discussion: This study has the limitations of a retrospective study.

Conclusion: A high success rate of open reduction and osteosynthesis with 2 miniplates can be guaranteed.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bone Plates / adverse effects
  • Bone Screws / adverse effects
  • Cranial Nerve Injuries / epidemiology
  • Cranial Nerve Injuries / etiology
  • Equipment Failure / statistics & numerical data
  • Female
  • Fracture Fixation, Internal / adverse effects*
  • Fracture Fixation, Internal / instrumentation
  • Fracture Fixation, Internal / statistics & numerical data
  • Fractures, Ununited / epidemiology
  • Fractures, Ununited / etiology
  • Humans
  • Male
  • Mandibular Fractures / surgery*
  • Middle Aged
  • Retrospective Studies
  • Trigeminal Nerve Injuries
  • Young Adult