Journal of Oral and Maxillofacial Surgery
Volume 66, Issue 11 , Pages 2203-2212 , November 2008

Do the Benefits of Rigid Internal Fixation of Mandible Fractures Justify the Added Costs? Results From a Randomized Controlled Trial

  • Vivek Shetty, DDS, Dr MedDent

      Affiliations

    • Professor, Section of Oral and Maxillofacial Surgery, University of California, Los Angeles, CA
    • Corresponding Author InformationAddress correspondence and reprint requests to Dr Shetty: Section of Oral and Maxillofacial Surgery, 23-009 UCLA School of Dentistry, 10833 Le Conte Avenue, Los Angeles, CA 90095-1668
    • ,
  • Kathryn Atchison, DDS, MPH

      Affiliations

    • Professor, Section of Public Health Dentistry, University of California, Los Angeles, CA
    • ,
  • Richard Leathers, DDS

      Affiliations

    • Assistant Professor, Department of Oral and Maxillofacial Surgery, Charles Drew University, Los Angeles, CA
    • ,
  • Edward Black, DDS

      Affiliations

    • Assistant Professor, Department of Oral and Maxillofacial Surgery, Charles Drew University, Los Angeles, CA
    • ,
  • Cory Zigler, MS

      Affiliations

    • Statistical Assistant, Section of Oral and Maxillofacial Surgery, University of California, Los Angeles, CA
    • ,
  • Thomas R. Belin, PhD

      Affiliations

    • Professor, Department of Biostatistics, University of California, Los Angeles, CA

References 

  1. Zachariades N, Mezitis M, Rallis G. An audit of mandibular fractures treated by intermaxillary fixation, intraosseous wiring and compression plating. Br J Oral Maxillofac Surg. 1996;34:293
  2. Hoffman WY, Barton RM, Price M, et al. Rigid internal fixation vs. traditional techniques for the treatment of mandible fractures. J Trauma. 1990;30:1032
  3. Thaller SR, Reavie D, Daniller A. Rigid internal fixation with miniplates and screws: A cost-effective technique for treating mandible fractures?. Ann Plast Surg. 1990;24:469
  4. Dodson TB, Pfeffle RC. Cost-effectiveness analysis of open reduction/nonrigid fixation and open reduction/rigid fixation to treat mandibular fractures. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995;80:5
  5. El-Degwi A, Mathog RH. Mandible fractures—Medical and economic considerations. Otolaryngol Head Neck Surg. 1993;108:213
  6. Schmidt BL, Kearns G, Gordon N, et al. A financial analysis of maxillomandibular fixation versus rigid internal fixation for treatment of mandibular fractures. J Oral Maxillofac Surg. 2000;58:1206
  7. Abubaker AO, Lynam GT. Changes in charges and costs associated with hospitalization of patients with mandibular fractures between 1991 and 1993. J Oral Maxillofac Surg. 1998;56:161
  8. Leathers R, Shetty V, Black E, et al. Orofacial injury profiles and patterns of care in an inner city hospital. Int J Oral Biology. 1998;23:53
  9. Shetty V, Atchison K, Der-Matirosian C, et al. The mandible injury severity score: Development and validity. J Oral Maxillofac Surg. 2007;65:663
  10. Ewing JA. Detecting alcoholism (The CAGE questionnaire). JAMA. 1984;252:1905
  11. Atchison KA. The general oral health assessment index. In:  Slade GD editors. Measuring Oral Health and Quality of Life. Chapel Hill, NC: University of North Carolina; 1997;p. 71–80
  12. Audige L, Hanson B, Kopjar B. Issues in the planning and conduct of non-randomized studies. Injury. 2006;37:340
  13. Bubbar VK, Kreder HJ. The intention-to-treat principle: A primer for the orthopaedic surgeon. J Bone Joint Surg Am. 2006;88:2097
  14. Angrist JD, Imbens GW, Rubin DB. Identification of causal effects using instrumental variables (with discussion). J Am Stat Assoc. 1996;91:444
  15. Ellis E, Carlson DS. The effects of mandibular immobilization on the masticatory system: A review. In:  Yaremchuk MJ,  Gruss JS,  Manson PN editor. Rigid Fixation of the Craniomaxillofacial Skeleton. Boston: Butterworth-Heinemann; 1992;
  16. Shetty V, Atchison K, Der-Martirosian C, et al. Determinants of surgical decisions about mandible fractures. J Oral Maxillofac Surg. 2003;61:808
  17. Fath JJ, Ammon AA, Cohen MM. Urban trauma care is threatened by inadequate reimbursement. Am J Surg. 1999;177:371
  18. Ehrenfeld M, Roser M, Hagenmaier C, et al. Treatment of mandibular fractures with different fixation techniques—Results of a prospective fracture study. Fortschr Kiefer Gesichtschir. 1996;41:67
  19. Wagner M. Concepts of fracture fixation. http://www.aofoundation.org/portal/AOFileServer/PortalFiles?FilePath=/Extranet/Active/_att/wor/act/Dialogue/2005_2/Concepts_of_fracture_fixation.pdfAccessed July 21, 2008
  20. Brown KA, Shetty V, Delrahim S, et al. Correlates of missed appointments in orofacial injury patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;87:405

 This study was conducted by the UCLA Facial Injury Research Center and supported by the National Institute on Drug Abuse (1R01-DA 16850) and National Institute of Dental and Craniofacial Research (P50/DE-10598).

PII: S0278-2391(08)01066-5

doi: 10.1016/j.joms.2008.06.058

Journal of Oral and Maxillofacial Surgery
Volume 66, Issue 11 , Pages 2203-2212 , November 2008

Article Tools

* Image Usage & Resolution