Mandible fractures--medical and economic considerations

This article retrospectively evaluates 1278 mandibular fractures and compares intermaxillary fixation, plating, and interosseous wiring as to outcomes and cost-effectiveness of treatment. The predominance of young men with personal altercations reflects the urban patient setting. The infection from plating exceeds other methods and this difference is also reflected in increased patient days (in the hospital) and an increased length of time for postoperative care. No significant differences are observed between treatments for non-union, malunion, facial nerve injury, or temporal mandibular joint problems. Other factors, such as site and severity of injury and experience of the surgeons are considered. Cost implications are important, but should be just one factor in evaluation for the best treatment for each patient.