Immediate versus delayed treatment of mandibular fractures: A stratified analysis of complications

Abstract

Purpose To analyze the rate of complication outcomes of mandibular fracture repairs across different injury-to-repair time spans. Patients and Methods We conducted a retrospective cohort study of patients with repaired mandibular fractures. The independent variable was the time span from injury to surgical repair. The primary outcome variable was the rate of complications measured postoperatively during the follow-up appointments. Other variables were grouped for performance of a stratified analysis: favorability of the fracture, patient compliance, substance abuse, and fracture location. Descriptive and bivariate statistics were computed. Results The final sample was composed of 505 patients, and the time span from injury to repair ranged from 0 to 90 days. The total number of patients from the sample with reported complications was 124. There was no statistical significance correlating the time spans and complication rates (P =.796). The variables for the stratified analysis also showed no significant correlations except for fracture location. Body fractures resulted in the highest rate of complications (33%; P =.041). Of the noncompliant patients (n = 144), 28.5% presented with complications (P =.352). No significance was seen in unfavorable fractures (n = 283), with a rate of complications of 28.6%. No significance could be correlated with substance abuse (n = 107, 29.9% with complications; P =.262). Conclusions The results of this study suggest that although time from injury to repair does not affect the rate of complications, the global standard of care for the management of non-emergent mandibular fractures should consider the cost-effectiveness of delaying treatment while exercising a reasonable length of delay for the comfort of the patient.