Outcome and complications after treatment of facial fractures at different times in polytrauma patients |
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Authors: | Rene Rothweiler Joerg Bayer Joern Zwingmann Norbert P. Suedkamp Johannes Kalbhenn Rainer Schmelzeisen Ralf Gutwald |
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Affiliation: | 1. Department of Oral and Maxillofacial Surgery, (Chairman: Prof. Dr. Dr. Rainer Schmelzeisen), Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Germany;2. Department of Orthopedics and Traumatology, (Chairman: Prof. Dr. Norbert P. Suedkamp), Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Germany;3. Department of Anesthesiology and Critical Care, (Chairman: Prof. Dr. Hartmut Buerkle), Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Germany;4. Danube Private University (DPU), Faculty of Medicine/Dentistry, Steiner Landstraße 124, 3500 Krems-Stein, Austria |
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Abstract: | Finding the correct point of time for operative treatment of facial fractures in multiply injured people remains one of the most important challenges in modern emergency medicine. Findings relating to pathophysiological mechanisms after severe trauma argue against the early operative treatment of non-life-threatening injuries. Our retrospective analysis investigated the effects on complications and outcome of different time points for operative treatment of maxillofacial fractures in multiply injured patients.Over a period of 10 years (2003–2012) we could identify 1543 patients, of whom 553 had fractures of the facial skull. 168 of the facial fracture patients were operated on their fractures, 97 at a time later than 72 h. Despite the delayed time of operation, the patients showed fewer complications (21.6% vs 25.4%). This resulted in fewer additional stays in hospital (9.3% vs 11.3%), and also in fewer plate removals (23.7% vs 33.8%). We conclude that delayed operative fracture treatment does not lead to more complications. The optimal time for operative treatment has to be determined individually as the earliest point at which no adverse effects from comorbidities are expected. |
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Keywords: | Polytrauma Maxillofacial fractures Damage control surgery Operative treatment |
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