title: Postoperative maxillomandibular fixation after open reduction of mandible fractures.
abstract: OBJECTIVE
  Patients are placed in maxillomandibular fixation (MMF) to restore premorbid occlusion prior to open reduction-internal fixation (ORIF) of mandibular fractures. Maintaining MMF for these patients for several weeks postoperatively is a widely accepted dictum.
  
  
  OBJECTIVE
  We compare postoperative ORIF outcomes in dentate patients with noncomminuted symphyseal, parasymphyseal, or angle fractures of the mandible between those who underwent postoperative MMF and those who did not.
  
  
  METHODS
  Retrospective review of medical records for 311 patients with 413 mandibular fractures treated at a level 1 public trauma center in the Fort Worth, Texas, metropolitan area. All patients were treated from August 1997 to August 2012 and had a minimum follow-up of 6 weeks.
  
  
  METHODS
  Of the 413 symphyseal, parasymphyseal, and angle fractures, 78, 63, and 83 patients were treated with postoperative MMF respectively. The group without postoperative MMF included 56 symphyseal fractures, 49 parasymphyseal fractures, and 84 angle fractures.
  
  
  METHODS
  Rates of wound dehiscence, infection, plate removal, nonunion, malunion, and malocclusion were compared.
  
  
  RESULTS
  Using an unpaired t test and α value of .05 for significance, the difference between the 2 groups' outcomes was not statistically significant for any of the complications evaluated. In the groups with vs without postoperative MMF, the mean numbers of complications were as follows: wound dehiscence, 4.7 vs 2.5 (95% CI, -1.7 to 6.0) (P = .16); infection, 6.7 vs 4.0 (95% CI, -1.7 to 7.0) (P = .14); plate removal, 2.3 vs 2.5 (95% CI, -7.9 to 7.6) (P = .94); nonunion, 1.0 vs 0.5 (95% CI, -2.2 to 3.2) (P = .59); malunion, 0.7 vs 1.0 (95% CI, -3.1 to 2.4) (P = .72); and malocclusion, 1.3 vs 1.0 (95% CI, -4.0 to 4.7) (P = .82).
  
  
  CONCLUSIONS
  The surgical dictum of maintaining postoperative MMF for all trauma patients after ORIF of the mandible may not be of advantage in the treatment of dentate patients with noncomminuted symphyseal, parasymphyseal, or angle fractures.
authors.affiliation: Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas.
authors.forename: Masoud
authors.initials: M
authors.lastname: Saman
authors.affiliation: New York Eye and Ear Infirmary, Mount Sinai Health System, New York.
authors.forename: Sameep
authors.initials: S
authors.lastname: Kadakia
authors.affiliation: Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas.
authors.forename: Yadranko
authors.initials: Y
authors.lastname: Ducic
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001860:Bone Plates; D003767:Dental Occlusion, Balanced; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D007103:Immobilization / Q000379:methods*; D008310:Malocclusion / Q000209:etiology / Q000517:prevention & control; D008334:Mandible / Q000601:surgery*; D008337:Mandibular Fractures / Q000601:surgery*; D008437:Maxilla / Q000601:surgery*; D008875:Middle Aged; D056948:Orthognathic Surgical Procedures / Q000379:methods*; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D012189:Retrospective Studies; D055815:Young Adult