Open Versus Closed Reduction of Maxillary Fractures: Complications and Resource Utilization

Area of Science:

• Oral and Maxillofacial Surgery
• Trauma Surgery
• Health Economics

Background:

• Maxillary fractures are managed variably based on surgeon preference, injury severity, and patient factors.
• Current literature lacks comparative data on costs and complications between open and closed reduction techniques for maxillary fractures.

Purpose of the Study:

• To compare the incidence of postoperative complications, length of stay, and total charges between open and closed reduction techniques for maxillary fractures.
• To identify patient- and injury-related factors associated with increased complication rates.

Main Methods:

• Analysis of the National Inpatient Sample (2006-2011) database for patients undergoing closed or open reduction of maxillary fractures.
• Complications defined as re-exploration, hemorrhage, hematoma, seroma, wound infection, or dehiscence.
• Risk-adjusted multivariate analysis to compare outcomes and identify risk factors.

Main Results:

• A total of 22,157 patients were analyzed (18,874 closed, 3283 open reduction).
• No significant difference in postoperative complication rates was observed between open and closed reduction approaches.
• Open reduction was associated with a shorter length of stay and lower total charges.
• Factors such as male sex, non-private insurance, Southern region, transferred status, chronic pulmonary disease, and coagulopathy increased complication risk.

Conclusions:

• While surgical approach does not influence complication rates, open reduction offers advantages in reduced length of stay and lower total charges.
• Future research should investigate the impact of comorbidities, demographics, and associated injuries on resource utilization for maxillary fractures.
• This data can inform management strategies in the current economic climate.