A Retrospective Study:The Effect Of Timing Of Rigid Internal Fixation On The Treatment Of Mandibular Fracture

Objective:This study reviewed the traumatic fractures in our department on patients with mandibular fracture,and explored the impact of rigid internal fixation on the incidence of postoperative complications and the rate of excellent outcomes after reduction,providing a reference for clinical work.Methods:The data of 99 patients with mandibular fractures treated in our department from October 2014 to October 2017 were collected using the electronic medical records system of the First Hospital of Jilin University,outpatient follow-up,and telephone follow-up.There were 71 males and28 females with a proportion of approximately 2.54:1;aged 12-71 years,mean age 38.1±12.2 years old.There were 63 cases?63.6%?of open fractures and 36 cases?36.4%?of closed fractures.With reference to domestic and foreign literature,changes in the degree of facial swelling with time after trauma,and fibrous osteophyte formation timing,the timing for the treatment of rigid internal fixation was sequentially grouped:group I:Patients who were treated within 2 days after trauma,17cases in total;group II:Patients who were treated from 3 days to 7 days after trauma,34 cases in total;group III:Patients who were treated from 8 days to 14 days after trauma,32 cases in total;group IV:Patients who were treated from 15 days to 21days,16 cases in total.Comparing the difference of the postoperative complications and the excellent rate of reduction effect between the four groups of patients with mandibular fractures,the best time for the treatment of mandibular fractures was explored.Statistical methods include:normal distribution data in measurement data are expressed as mean±standard deviation,using one-way analysis of variance;count data using chi-square test,Fisher's exact test results prevail.P<0.05 was considered statistically significant.Results:The 99 patients with mandibular fractures from October 2014 to October 2017 were followed up for 3-12 months.The results are as follows:1.The incidence of postoperative complications:2 patients in group I?11.8%?,4 patients in group II?11.8%?,3 patients in group III?9.4%?,2patients in group IV?12.5%?,c^?17?=0.456,P=1.000>0.05,there was no significant difference between the groups;2.The rate of excellent outcomes after reduction:17 cases?100.0%?ingroup I,33 cases?97.1%?in group II,30 cases?93.8%?in group III,12cases?75.0%?in group IV,c^?17?=7.020,P=0.031<0.05,there were statistical differences between the groups.After pairwise comparisons:group I compared with group IV,P=0.044<0.05,the difference was statistically significant;group II compared with group IV,P=0.031<0.05,the difference was statistically significant;the remaining pairwise comparisons were no statistical significance.Conclusions:1.For patients with mandibular fractures,there was no significant difference in the incidence of postoperative complications at different treatment timing.Early treatment did not increase the incidence of postoperative complications;2.For patients with mandibular fractures,the effect of reduction within7 days of treatment was better than that of treatment 15 days to 21 days.