title: A multi-outcome analysis of the effects of treatment timing in the management of zygomatic fractures.
abstract: The aim of this study was to analyze the effects of surgical treatment delay in the management of zygomatic fractures. A retrospective case series of 99 patients was undertaken. Four outcome measures were analyzed in relation to delay: facial symmetry, facial scarring, trismus, and radiographic outcome. Five additional variables were subsequently analyzed: operation, diagnosis, primary operator, regular alcohol use, and regular cigarette use. Statistically significant associations were found between delay and facial scarring, and delay and radiographic outcome. For each additional delay of a day, the odds of facial scarring being present, compared to absent, decreased by 13% (odds ratio (OR) 0.87, 95% confidence interval (CI) 0.76-0.98). For regular cigarette users, for each additional day of delay there was a 306-fold increased risk of having a radiographic outcome of major deviation from premorbid compared to equivalent to premorbid (OR 306.38, 95% CI 2.08-45,161.49). For non-regular cigarette users/non-users, for each additional day of delay there was a 1.5-fold increased risk of having a radiographic outcome of major deviation from premorbid compared to equivalent to premorbid (OR 1.50, 95% CI 1.08-2.09). These findings correlate with commonly held beliefs and anecdotal evidence. Despite the limitations, this study allows for an evidence-based approach to the timing of treatment of zygomatic fractures.
authors.affiliation: School of Medicine, University of Queensland, Brisbane, Queensland, Australia. Electronic address: michael.hurrell@uqconnect.edu.au.
authors.forename: M J L
authors.initials: MJ
authors.lastname: Hurrell
authors.affiliation: Maxillofacial Department, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
authors.forename: S C
authors.initials: SC
authors.lastname: Borgna
authors.affiliation: School of Public Health, University of Queensland, Brisbane, Queensland, Australia.
authors.forename: M C
authors.initials: MC
authors.lastname: David
authors.affiliation: Maxillofacial Department, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
authors.forename: M D
authors.initials: MD
authors.lastname: Batstone
mesh_terms: D000328:Adult; D002921:Cicatrix / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D011793:Queensland / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012887:Skull Fractures / Q000453:epidemiology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D014313:Trismus / Q000453:epidemiology; D015050:Zygoma / Q000293:injuries*
keywords: delay; fracture; outcome; timing; treatment; zygoma; zygomatic