Accuracy and outcome of mandibular fracture reduction without and with an aid of a repositioning forceps

• Published in: Oral and maxillofacial surgery Vol. 23; no. 2; pp. 201 - 208
• Main Authors: Batbayar, Enkh-Orchlon, Malwand, Somaia, Dijkstra, Pieter U., Bos, Ruud R. M., van Minnen, Baucke
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-06-2019; Springer Nature B.V
• Subjects: Dentistry; Fractures; Maxillofacial surgery; Medicine; Medicine & Public Health; Oral and Maxillofacial Surgery; Original; Original Article; Patients; Surgeons; Surgical outcomes; Surgical instruments; Mandibular fracture; Open fracture reduction; Postoperative complications
• ISSN: 1865-1550; 1865-1569
• DOI: 10.1007/s10006-019-00759-0

Purpose
It is presumed that adequate reduction of a fracture of the mandible favors bone healing and diminishes the risk of complications. In this retrospective study, we compared the accuracy of fracture alignment and complication rate of mandibular fractures reduced without or with aid of a repositioning forceps.
Methods
Retrospective analysis of consecutive 252 patients with mandibular fractures treated between January 2010 and December 2016. Eligible for this study were patients with isolated mandibular fractures needing open reduction and internal fixation in whom pre- and postoperative radiographs and patient records were available. In total, 131 (252 fractures) patients fulfilled the inclusion criteria.
Results
Seventy-one (54%) patients were men. Mean age of the patients was 33 ± 16.5 years, and the median and interquartile range of age was 25 (20;41). In 54 patients, mandibular fractures were reduced without the aid of repositioning forceps, and in the remaining 77 patients, the fractures were reduced with the aid of the repositioning forceps. Anatomical alignment of the fractures was poor in the non-forceps-aided group (48%) compared to the forceps-aided group (58%) (
P
 = .067). Overall complication rate was higher in the group of fractures reduced without the aid of forceps (17%) than in the forceps-aided group (7%) (
P
 = .045; OR, 2.7; 95% CI, 1.0–7.4).
Conclusions
Mandibular fractures reduced with the aid of repositioning forceps are accompanied by a lower complication rate and better alignment. This is an important observation as better alignment of the fracture fragments favors bone healing and reduces complications.