| Summary: | A research report submitted to the Faculty of Health Sciences, University of the
Witwatersrand, Johannesburg, in partial fulfillment of the requirements for the
degree of Master of Dentistry in the branch of Maxillofacial and Oral Surgery
Johannesburg, 2016. === Aim: The aim of the study was to compare the infection rates between
mandibular fractures treated by closed reduction and those treated by open
reduction with internal fixation.
Methodology: This was a randomized prospective study in which 119 patients
withclass 1 mandibular fractures (fractures bound by teeth on either side) were
randomly allocated into two treatment groups, a closed and an open reduction
with internal fixation. Parameters such as site of fracture, seniority of surgeon,
cause of fracture, date of injury and site of infection were all recorded. Statistical
analysis was used to compare the rates of infection between the two treatment
groups.
Results: Of the 119 patients, 88.2% were males while 11.8% were females. The
ages ranged from 18 to 59 years with a mean of 29.9 years. The angle of the
mandible was the most fractured site (70 of the 161 fractures). Blunt trauma due
to interpersonal violence (82.5%) was the predominant cause of the injuries.
Overall, the infection rate in this study was 13.5%. Most infections occurred
within ten days of treatment. The highest infection rate was in the open reduction
and internal fixation group (21.7%). The closed reduction group had a 5.1%
infection rate.
Conclusion: The study showed that there was a statistically significant
difference in the infection rates between both groups, higher in the open than in
the closed treatment group (P value = 0.014). Seniority of the surgeon, patients’
age, compliance and presence of comorbidities did not seem to influence the
outcome in this study. === MT2017
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