Complications of mandible fractures related to substance abuse

To analyze different epidemiologic factors related to patients who abuse legal and illegal substances, and the relationship between substance abuse and postsurgical complications of mandibular fractures.

The study was performed over a 5-year period by the Division of Oral and Maxillofacial Surgery, State University of Campinas, São Paulo, Brazil. In total, 1,399 patients were analyzed via a data form covering age, gender, socioeconomic activity, etiology, and time lapse between trauma and medical attention. Patients were categorized according to whether they reported no substance abuse, smoking, chronic abuse of alcohol, or abuse of intravenous or nonintravenous drugs. Information on the complications presented and corresponding treatments was also included.

Of 1,399 patients, 472 presented with 699 mandibular fractures, and 11.4% of these patients had postsurgical complications. The breakdown of subgroup size in terms of percentage of the total, and the corresponding incidence of postsurgical complications, were: for those reporting no substance abuse (52.5%), 8.5% of total complications; for smokers (35.3%), 14.9% of total complications; for patients who self-reported chronic alcohol abuse (30.9 %), 17.1% of total complications; for the nonintravenous drug user subgroup (6.1%), 14.2% of total complications; and for the intravenous drug user subgroup (1.8%), 37.5% of total complications.

There is evidently a close correlation between substance abuse and postsurgical complications in patients with mandibular fractures, because of both physiologic alterations and patient behavior. Assault-related injuries were the primary cause of trauma in the substance abuse groups, and infections represented the predominant complication.