European Journal of Cardiovascular Medicine

Delays in the repair of facial fractures due to traumatic injuries are inevitable. They often present with other systemic injuries that merit more acute consideration, so facial fracture repair is secondary. Controversy exists in the management of patients with isolated mandibular fractures regarding the timing of repair. Many authors advocate immediate repair with open reduction internal fixation (ORIF) and/or maxillo-mandibular fixation (MMF), while others advocate a delay in repair to allow for reduction of surrounding soft tissue edema. Regardless, complications of mandibular fractures often develop, including infections, hardware exposure, nonunion, and jaw pain. Materials and Methods: The records of patients with facial fractures admitted to the department of plastic surgery in a tertiary hospital in central India during the two years between 2021 and 2023 were reviewed retrospectively. Exclusion criteria for the study included patients with incomplete records and pan-facial fractures such as LeFort and naso-orbital-ethmoid fractures. This allowed us to evaluate all isolated mandibular fractures during the study period. Results: All patients in the immediate group underwent MMF (four backs) and 20 underwent ORIF. 28 patients in the delayed group underwent MMF (four posterior) and 24 underwent ORIF. The median time on MMF was five weeks (range three to eight weeks) for the delayed group and 4.5 weeks (range two to eight weeks) for the delayed group. 14 of the 34 patients in the immediate group reported alcohol, tobacco, or illicit drug use. 12 patients refused to use any of these substances, and 8 patients used undocumented drugs. In the delayed group, 20 of 32 patients reported isolated or concurrent use of alcohol, tobacco, or illicit drugs, and 12 patients reported no substance use. 2 patients in the delayed group experienced previous mandibular trauma, and 2 patients in the immediate group was in the first trimester of pregnancy. Conclusion: The rate of complications did not increase when fracture repair was delayed for more than 72 hours, while drug addiction increased complications. Outpatient triage with elected repair of isolated mandibular fractures appears to be less expensive than inpatient management.