Resident LSUHSC - New Orleans New Orleans, Louisiana
Abstract: PURPOSE Post-operative maxillomandibular fixation (MMF) has the potential to reduce complications following open reduction and internal fixation (ORIF) of mandibular angle fractures. The purpose of this study is to determine if a short duration of MMF is associated with a reduced rate of post-operative inflammatory complications (POICs) in patients with mandibular angle fractures. METHODS The authors conducted a retrospective cohort study consisting of patients treated with ORIF for mandibular angle fractures from 8/1/2015 to 5/31/2020. The primary predictor variable of this study was the use and duration of post-operative MMF. The outcome variable of interest was the presence of POICs. Categorical covariates were compared using Fisher exact tests, while continuous variables were compared using Wilcox rank-sum tests. Multivariable logistic regression adjustment was done using Bayesian variable selection. RESULTS There were 350 patients included in the study, 85.4% of which were men. The average age was 32.5 years. Patients with 1-2 weeks of MMF had a POIC rate of 8.3% compared to 18.2% for no MMF and 41.9% for MMF greater than 2 weeks (p < 0.001). In the adjusted analysis, patients with MMF time of 1-2 weeks had a significant decrease in POIC risk compared to 0 weeks (aOR = .65, 95% CI = .43-.99), while patients with 2+ weeks MMF time had increased risk (aOR = 1.55, CI=1.21-1.99). CONCLUSION The findings from our study suggest that the use of 1-2 weeks of post-operative MMF may reduce POICs following ORIF of mandibular angle fractures. REFERENCES Kim MY, Kim CH, Han SJ, Lee JH: A comparison of three treatment methods for fractures of the mandibular angle. Int J Oral Maxillofac Surg 45:878, 2016 Lazow SK, Tarlo I: Mandible fracture: transoral 2.0-mm locking miniplate plus 1 week maxillomandibular fixation. Atlas Oral Maxillofac Surg Clin North Am 17:27, 2009