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Service evaluation: repeat of open reduction and internal fixation of fractured mandibles
Poster Presentations / British Journal of Oral and Maxillofacial Surgery 50S (2012) S42–S66
resources and patient interventional strategies. The maxillofacial region is the most common target in assault-related injuries and there is a strong link between alcohol consumption and these injuries. Conclusion: The majority of alcohol-related facial fractures were due to interpersonal violence in our Unit. The demographics reflect that young men are mainly affected and there is a statistically significant correlation between alcoholrelated trauma and hospitalisation. Oral and Maxillofacial surgeons have an important role in preventive education as well as treatment of alcohol-related facial injuries.
S65
Yet, slightly different approach between practicing team members, no significant difference in the treatment outcome within Oral Maxillofacial for treatment of Mandibular trauma. http://dx.doi.org/10.1016/j.bjoms.2012.04.141 P63 Mandibular fractures. . .what makes a “difficult” case difficult? S. Liyanage ∗ , M. Perry Ulster Hospital, Northern Ireland, United Kingdom
Reference 1. Hutchison IL, Magennis P, Shepherd JP, Brown AE. The BAOMS United Kingdom survey of facial injuries part 1: aetiology and the association with alcohol consumption. Br J Oral Maxillofac Surg 1998;36:3–13.
http://dx.doi.org/10.1016/j.bjoms.2012.04.140 P62 Service evaluation: repeat of open reduction and internal fixation of fractured mandibles A. El-Awa ∗ , K. Wenham, J. Yates, N. Lee Sheffield Teaching Hospitals, Charles Clifford Dental Hospital, United Kingdom Introduction/aims: The aim of the study was to look into the cases presenting with mandibular fractures and identify the numbers of cases that required further surgery relating to the fracture, essentially repeat surgery of open reduction and internal fixation or closed fixation without further plating. Additionally, why was the second procedure required and if there was any patient related factors. In general; we wanted to assess if the treatment provided complied with the currently regarded as acceptable standards within Oral and Maxillofacial surgery, to identify the cause of repeat surgery and any areas with need for improvement. Methods/materials: We looked into our trauma database from January 2005 to December 2010 to identify all the cases that had mandibular fractures surgery in those 6 years. Case notes assessed retrospectively. Results/statistics: 23 (4.08%) patients required repeat surgery that related to mandibular fracture. Open surgery still varied from single plate fixation and two-plate fixation. Infection was the primary cause of second surgery, which was accompanied by fracture mobility, dental infection, poor occlusion, or fractured plate. Out of the 23 cases, 7 required re application of the plate fixation while the other 16 cases they only needed InterMaxillary fixation and soft diet for and extended period of time. Conclusions/clinical relevance: In general, treatment for mandibular fractures at Sheffield complies with what is currently regarded as acceptable treatment approach.
Introduction/aims: The aim of this study was to identify how influential known complicating factors were thought to be in the management of mandibular fractures. Materials/methods: The investigators performed a literature review to identify those factors reported to complicate mandibular fracture management. A visual analogue scale (VAS) questionnaire was then formulated based on these factors. UK-based consultant Oral and Maxillofacial surgeons known to have experience of and an interest in managing trauma were contacted and asked to rate the effect of each complicating factor on the planning and treatment of a mandibular fracture. The degree of influence of each complicating factor was derived using the visual analogue scale (0–10). From the results a mean “peer score” and a range of scores for each factor was derived. Results/statistics: 60 colleagues were contacted. There were 48 respondents. The majority of complicating factors exhibited considerable variability in both the mean “peer score” and ranges of scores recorded. The only exception to this was the presence of comminution at fracture sites, which consistently received relatively high scores. There was no consistency between scores allocated by different consultants. Conclusions/clinical relevance: Considerable variation in the importance of many of the complicating factors in the management of mandibular fractures was noted. This study shows that no real consensus amongst clinicians as to what was regarded as a “difficult” mandibular fracture existed. http://dx.doi.org/10.1016/j.bjoms.2012.04.142 P64 Recognition and management of vision-threatening injuries secondary to facial trauma F. McClenaghan ∗ , D. Ezra, S. Holmes Barts and The London, United Kingdom Introduction: Blindness is an uncommon but serious complication of facial trauma (0.2–22%). The majority of visual loss after facial trauma is due to indirect traumatic optic
resources and patient interventional strategies. The maxillofacial region is the most common target in assault-related injuries and there is a strong link between alcohol consumption and these injuries. Conclusion: The majority of alcohol-related facial fractures were due to interpersonal violence in our Unit. The demographics reflect that young men are mainly affected and there is a statistically significant correlation between alcoholrelated trauma and hospitalisation. Oral and Maxillofacial surgeons have an important role in preventive education as well as treatment of alcohol-related facial injuries.
S65
Yet, slightly different approach between practicing team members, no significant difference in the treatment outcome within Oral Maxillofacial for treatment of Mandibular trauma. http://dx.doi.org/10.1016/j.bjoms.2012.04.141 P63 Mandibular fractures. . .what makes a “difficult” case difficult? S. Liyanage ∗ , M. Perry Ulster Hospital, Northern Ireland, United Kingdom
Reference 1. Hutchison IL, Magennis P, Shepherd JP, Brown AE. The BAOMS United Kingdom survey of facial injuries part 1: aetiology and the association with alcohol consumption. Br J Oral Maxillofac Surg 1998;36:3–13.
http://dx.doi.org/10.1016/j.bjoms.2012.04.140 P62 Service evaluation: repeat of open reduction and internal fixation of fractured mandibles A. El-Awa ∗ , K. Wenham, J. Yates, N. Lee Sheffield Teaching Hospitals, Charles Clifford Dental Hospital, United Kingdom Introduction/aims: The aim of the study was to look into the cases presenting with mandibular fractures and identify the numbers of cases that required further surgery relating to the fracture, essentially repeat surgery of open reduction and internal fixation or closed fixation without further plating. Additionally, why was the second procedure required and if there was any patient related factors. In general; we wanted to assess if the treatment provided complied with the currently regarded as acceptable standards within Oral and Maxillofacial surgery, to identify the cause of repeat surgery and any areas with need for improvement. Methods/materials: We looked into our trauma database from January 2005 to December 2010 to identify all the cases that had mandibular fractures surgery in those 6 years. Case notes assessed retrospectively. Results/statistics: 23 (4.08%) patients required repeat surgery that related to mandibular fracture. Open surgery still varied from single plate fixation and two-plate fixation. Infection was the primary cause of second surgery, which was accompanied by fracture mobility, dental infection, poor occlusion, or fractured plate. Out of the 23 cases, 7 required re application of the plate fixation while the other 16 cases they only needed InterMaxillary fixation and soft diet for and extended period of time. Conclusions/clinical relevance: In general, treatment for mandibular fractures at Sheffield complies with what is currently regarded as acceptable treatment approach.
Introduction/aims: The aim of this study was to identify how influential known complicating factors were thought to be in the management of mandibular fractures. Materials/methods: The investigators performed a literature review to identify those factors reported to complicate mandibular fracture management. A visual analogue scale (VAS) questionnaire was then formulated based on these factors. UK-based consultant Oral and Maxillofacial surgeons known to have experience of and an interest in managing trauma were contacted and asked to rate the effect of each complicating factor on the planning and treatment of a mandibular fracture. The degree of influence of each complicating factor was derived using the visual analogue scale (0–10). From the results a mean “peer score” and a range of scores for each factor was derived. Results/statistics: 60 colleagues were contacted. There were 48 respondents. The majority of complicating factors exhibited considerable variability in both the mean “peer score” and ranges of scores recorded. The only exception to this was the presence of comminution at fracture sites, which consistently received relatively high scores. There was no consistency between scores allocated by different consultants. Conclusions/clinical relevance: Considerable variation in the importance of many of the complicating factors in the management of mandibular fractures was noted. This study shows that no real consensus amongst clinicians as to what was regarded as a “difficult” mandibular fracture existed. http://dx.doi.org/10.1016/j.bjoms.2012.04.142 P64 Recognition and management of vision-threatening injuries secondary to facial trauma F. McClenaghan ∗ , D. Ezra, S. Holmes Barts and The London, United Kingdom Introduction: Blindness is an uncommon but serious complication of facial trauma (0.2–22%). The majority of visual loss after facial trauma is due to indirect traumatic optic