Resident University of Maryland School of Medicine Baltimore, Maryland
Background: Facial trauma is managed with a combination of open and closed treatment modalities; however, the impact of the Covid-19 pandemic on facial trauma management remains uncertain. Learning Objectives: Develop a greater understanding of facial trauma management. Study Objective: To determine whether the management of facial trauma varied following the Covid-19 pandemic. Design Type: 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. Method: Adults were stratified into pre-Covid (before March 2020) and post-Covid groups. The primary outcomes included open reduction internal fixation (ORIF) alone, maxillomandibular fixation (MMF) alone, ORIF 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 significantly (pre-Covid, n=9, 23%; post-covid, n = 1, 2%; p=0.005). Among those with condylar fractures, a greater proportion of post-covid patients underwent ORIF and MMF (n=4, 100%) versus pre-Covid patients (n=2, 15%; p=0.006). 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). Conclusion: While the clinical characteristics of patients presenting with facial trauma did not differ significantly following the Covid-19 pandemic, the role of MMF in the management of mandible fractures changed significantly.