Intermaxillary fixation compared to miniplate osteosynthesis in the management of the fractured mandible: an audit

The hospital records of 30 patients with isolated fractured mandibles treated by intermaxillary fixation (IMF) were compared to 30 patients treated by miniplate osteosynthesis. The treatment variables assessed were the period of hospitalisation, the operating time, the use of intensive care or nurse specialing services, the number of outpatient visits, and the cost of materials. The cost of each facility was calculated from six sources, so that the average cost of each method of treatment could be determined. The results showed that the average cost for managing a fractured mandible with IMF was 1000 pounds if the intensive therapy unit (ITU) was used and 919 pounds if ward specialing services (a single nurse looking after the patient) were used. This compared with an average cost of 794 pounds for miniplate osteosynthesis. The extra cost of the materials if miniplates were used could be discounted by the longer period of hospitalisation, the use of ITU or nurse specialising services, and the greater number of outpatient visits that were required for patients treated with IMF. In addition the use of IMF significantly increased the time patients spent off work.