Outcomes Of Early And Delayed Intervention Of Maxillofacial Trauma

Background: Maxillofacial trauma is routinely evaluated on the basis of high and low velocity injuries, types of fractures in the literature. On the other hand, we have evaluated them on the basis of timing of surgery after trauma and their outcomes. In India RTA (Road traffic accidents) scenario is quite different from other countries. The highway traffic consists of a variety of vehicles from a cyclist, a two-wheeler, a four-wheeler to a heavy loaded truck. Animals like cows and dogs frequent the highways. Hence, we have classified the patients based on Single jaw and Panfacial fractures with or without the presence of extensive soft tissue injuries. Materials and Methods: In this retrospective record-based descriptive study, 200 patients that were treated at Sri Aurobindo Hospital between January 2023 to July 2024 for maxillofacial trauma were reviewed. Of which 176 patients were surgically operated, averaging 30 years of age and ranging from 12-70 years. For the purpose of our study these 176 patients were categorized into two groups, first of single jaw fractures(108 patients) and second of Panfacial fractures (68 patients). Single Jaw fractures were further divided as mandibular (84 patients); maxilla & zygomaticomaxillary complex fractures (24 patients). These were further evaluated and categorized as those patients who were treated within 72 hours (Early) and after 72 hours (Delayed) following injury. All patients of both the groups were treated with open reduction and internal fixation. Individual complications that of soft tissue dehiscence, plate/bone exposure, bone graft rejection, oroantral/palatal fistula, non-union of fractured segments, infections were analyzed. These complications were again assessed on the basis of their timing; those occurring within 72 hours and those after 72 hours. Results: When each type of complication was compared and evaluated, there was significantly more complication noted among delayed group than in early group. Conclusion: The restoration of the aesthetics and functionality of the face, post-trauma is a critical and an arduous task. As the anatomical complexity of the face must be addressed, timely intervention to achieve optimal functional and aesthetic outcomes is pertinent. Thus, the treatment should be done at the earliest when feasible