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Need for Redo Surgery of Maxillofacial Fractures
Hanna Thorén1, Sami Suojanen1, Anna Liisa Suominen2
1Department of Oral and Maxillofacial Surgery, Institute of Dentistry, University of Turku, 20520 Turku, Finland.
Craniomaxillofacial Trauma & Reconstruction
|April 24, 2025
Summary
Redo surgery for facial fractures is infrequent but highlights the need for surgical skill. Suboptimal procedures, particularly for zygomatic or mandibular fractures, were the main cause, emphasizing careful technique in maxillofacial surgery.
Area of Science:
- Oral and Maxillofacial Surgery
- Trauma Surgery
- Reconstructive Surgery
Background:
- Redo surgery for facial fractures addresses complications and suboptimal outcomes.
- Identifying factors influencing redo surgery is crucial for improving patient care.
- Mandibular and midfacial fractures often require complex surgical management.
Purpose of the Study:
- To describe patient demographics and clinical features of those needing redo surgery for mandibular and/or midfacial fractures.
- To identify factors associated with an increased likelihood of requiring redo surgery.
- To analyze the reasons for redo surgery in maxillofacial trauma patients.
Main Methods:
- Retrospective analysis of 1176 patients undergoing open reduction and fixation for mandibular and/or midfacial fractures or orbital reconstructions.
- Identification and characterization of patients who underwent redo surgery.
- Statistical analysis to determine associations between redo surgery and explanatory variables.
Main Results:
- 2.1% (25 out of 1176) of patients required redo surgery for 28 fracture sites.
- Inadequate reduction of zygomatic process or mandible (19 patients) and orbital reconstructions (4 patients) were the most common reasons.
- Combined mandibular and midface surgery showed a trend towards higher redo rates, though not statistically significant.
Conclusions:
- While redo surgery is uncommon, suboptimal surgical procedures are the primary driver, underscoring the importance of surgical expertise.
- Accurate fracture reduction and meticulous surgical technique are paramount for successful outcomes in maxillofacial trauma.
- Intraoperative CT and patient-specific implants may enhance the success of complex midfacial and orbital reconstructions.
