[Epidemiology and management in emergency room patients with maxillofacial fractures].
OBJECTIVE
To minimize overall mortality and optimise reconstructive and cosmetic outcome in severely injured patients with maxillofacial injuries the interdisciplinary coordination of several surgical disciplines is required. It is still discussed controversy whether patients with maxillofacial fractures benefit from early fracture repair or if delayed operative management also yields in good results.


METHODS
Herein we analysed the data of 1252 severely injured patients between May 1998 through June 2002 in our trauma department regarding fractures of the maxillofacial region, injury severity, length of ICU stay and postoperative complications in patients with either early (within 72 hours) or delayed ( > 3 days) facial fracture repair.


RESULTS
147 patients had severe facial fractures. Average age was 39.8 years (3-87 years), mean ICU was 25 (+/- 16) and the overall mortality 12% (n = 18). The most common cause for the injuries were traffic accidents in 45%. 78 patients (53%) underwent surgical repair of the maxillofacial fractures; 18 patients had early fracture repair and 60 patients had delayed operative repair. We found 4 complications (22%) in the early repair group and 13 local complications (21%) in the group with delayed surgical repair.


CONCLUSIONS
Delayed repair of maxillofacial injuries in severely injured patients is feasible and yields in good results compared to early fracture repair.
Kühne
Christian A
CA
Universitätsklinikum Essen, Klinik für Unfallchirurgie, Hufelandstr. 55, 45122 Essen, Germany. christian.kuehne@uni-essen.de
Krueger
C
C
Homann
M
M
Mohr
C
C
Ruchholtz
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D003299:Cooperative Behavior; D003422:Critical Care; D004636:Emergency Service, Hospital; D004954:Esthetics; D005147:Facial Bones / Q000293:injuries* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008440:Maxillary Fractures / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery; D008875:Middle Aged; D009104:Multiple Trauma / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery; D010348:Patient Care Team; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000401:mortality; D011859:Radiography; D012151:Resuscitation; D012887:Skull Fractures / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery; D016019:Survival Analysis