Factors Associated With Complications and Failure in Transoral, Mandible Fracture Repair

Open reduction internal fixation (ORIF) of the mandible has been a well-studied topic. However, there has not been a study investigating the relationship between suture type and complications.

A retrospective chart review of patients who sustained mandibular fractures was conducted at an urban level I trauma center (2010-2018). Descriptive statistics were used to categorize the sociodemographic data. χ 2 and Mann-Whitney U testing were used to compare variables between the polyglactin 910 (vicryl) and chromic sutured groups.

The study cohort consisted of 102 patients who underwent ORIF of the mandible through the transoral approach. Fifty-nine (57.8%) patients were closed with vicryl suture, whereas 43 (42.2%) with chromic gut suture. There were no differences in sociodemographics, immune status, substance abuse status, fracture type, time to repair, and managing care team between the two groups. Both groups had similar rates of wound dehiscence, infection, and revision surgery. Patients who were operated on earlier were more likely to experience a postoperative infection and dehiscence compared with patients operated on later ( P = 0.029 and P = 0.008, respectively). Smokers were more likely to experience dehiscence compared with nonsmokers ( P = 0.001). Females and immunocompromised patients were more likely to require revision surgery ( P < 0.001).

Suture type for transoral, ORIF of the mandible does not impact the rate of infection, wound dehiscence, and revision surgery. However, risk factors for complications can include early operative repair, smoking, female sex, and immunosuppression.