Mandible Fractures Undergoing Transfer Rarely Require Acute Intervention.

Area of Science:

• Plastic Surgery
• Trauma Surgery
• Oral and Maxillofacial Surgery

Background:

• Mandibular fractures are common traumatic injuries requiring specialized surgical management.
• Patients with these injuries are frequently transferred to tertiary care centers.
• The necessity and benefit of emergent interfacility transfer for mandibular fractures require evaluation.

Purpose of the Study:

• To assess the benefits and necessity of emergent transfer for patients with mandibular fractures.
• To identify patient subgroups that benefit most from transfer to a specialized trauma center.

Main Methods:

• Retrospective review of 406 patients with mandibular fractures treated at a Level I trauma center (January 2017–May 2020).
• Data collected included demographics, injury mechanism, presentation type, treatment, and time to intervention.
• Statistical analyses included descriptive statistics, t-tests, Fisher's exact test, chi-square tests, and multivariate regression.

Main Results:

• 36% (145/406) of patients were transferred from outside hospitals.
• Only one patient required Emergency Department intervention.
• Transferred patients with open injuries and pediatric patients showed a benefit from transfer, with 5.5% admitted for operative management.

Conclusions:

• Most isolated mandibular fractures do not necessitate emergent transfer to tertiary care facilities and can be managed on an outpatient basis.
• Acute interfacility transfer for these injuries represents a significant, often unnecessary, healthcare cost.
• Pediatric patients and those with open fractures warrant urgent transfer for specialized evaluation and management.