Effect of Early Versus Delayed Treatment on Clinical Outcomes of Mandibular Fractures: A Prospective Observational Study

BackgroundThe optimal timing of definitive treatment for mandibular fractures remains debated.Although early intervention may facilitate fracture stabilization and functional recovery, treatment may be delayed because of associated injuries, medical conditions, patient-related factors, or limited surgical resources.This study evaluated the clinical outcomes of early versus delayed treatment of mandibular fractures and assessed the factors contributing to treatment delays. MethodsThis prospective observational study included 100 dentulous patients with mandibular fractures who presented to the Department of Oral and Maxillofacial Surgery, Government Dental College, Thiruvananthapuram, and the dental casualty of Government Medical College, Thiruvananthapuram.Patients were divided into an early-treatment group, consisting of patients treated within three days, and a delayed-treatment group, consisting of patients treated on or after the fourth day.Clinical outcomes including infection, malocclusion, paresthesia, trismus, and tenderness were assessed at the initial postoperative visit, one week, and four weeks.The causes of treatment delay and type of intervention were also recorded.Statistical analysis was performed using nonparametric tests, with p < 0.05 considered statistically significant. ResultsOf the 100 patients, 50 received definitive treatment within three days of injury and 50 on or after day four.Initial infection rates were 16% and 8%, respectively (p = 0.218), with no infections in either group at four weeks.Malocclusion decreased from 96% to 24% in the early-treatment group and from 86% to 54% in the delayed-treatment group; the four-week difference was statistically significant (p = 0.002).Paresthesia showed no significant between-group differences (four-week p = 0.488).At four weeks, trismus and tenderness were absent in the early-treatment group but persisted in 27 patients in the delayed-treatment group for each outcome (p < 0.001).Neurological observation was the leading reason for delay (24 cases), followed by unsatisfactory closed reduction (nine), hospital referral (five), patient noncompliance (four), intensive care requirements (three), orthopedic intervention (three), and operating theatre unavailability (two). ConclusionEarly treatment of mandibular fractures was associated with more rapid resolution of malocclusion, trismus, and tenderness during follow-up.Infection and paresthesia did not differ significantly between treatment groups.The findings emphasize the potential importance of timely definitive management while recognizing that treatment timing must be considered in the context of associated injuries and other clinical factors.