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Craniomaxillofacial Trauma & Reconstruction is published by MDPI from Volume 18 Issue 1 (2025). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Sage.
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Article

Revision Surgery with Refixation After Mandibular Fractures

by
Claudius Steffen
1,*,
Margrit Welter
1,
Heilwig Fischer
1,2,3,
Maximilian Goedecke
1,
Christian Doll
1,
Steffen Koerdt
1,
Kilian Kreutzer
1,
Max Heiland
1,
Carsten Rendenbach
1 and
Jan O. Voss
1,3
1
Department of Oral and Maxillofacial Surgery, Charité–Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
2
Center for Musculoskeletal Surgery, Charité–Universitätsmedizin Berlin, Berlin, Germany
3
BIH Charité Clinician Scientist Program, BIH Biomedical Innovation Academy, Berlin Institute of Health at Charité–Universitätsmedizin Berlin, Berlin, Germany
*
Author to whom correspondence should be addressed.
Craniomaxillofac. Trauma Reconstr. 2024, 17(3), 214-224; https://doi.org/10.1177/19433875231179318
Submission received: 1 November 2022 / Revised: 1 December 2022 / Accepted: 1 January 2023 / Published: 5 June 2023

Abstract

Study Design: Retrospective, descriptive observational study. Objective: The need for revision surgery after mandibular fractures is an indicator for severe postoperative complications. This study aimed to characterise this patient cohort, describe solutions to deal with complications and evaluate treatment quality as a risk variable for complications. Methods: Patients with revision surgery with refixation after open reduction and internal fixation (ORIF) of a mandible fracture were included. Patient- and therapy-specific information were assessed together with postoperative complications. The quality of fixation was evaluated individually by 6 specialists. Interobserver agreement was analysed using Fleiss’ kappa. Results: Out of 630 patients, inclusion criteria were met by 17 patients (14 male, 3 female) with an average age of 43.3 (±15.5) years. Complications at the mandible body/angle/symphysis led to refixation in all cases. Main indications for refixation were osteomyelitis (52.9%) or pseudarthrosis (41.2%). Risk factors were drug-related immune suppression, local infection or substance abuse (nicotine, alcohol or drugs). Six patients did not present any of these predictors. Of these, treatment of 4 patients was rated as not in accordance to the AO principles. The interrater reliability of treatment quality assessments was 0.239. Conclusions: Patients with risk factors need to be carefully observed perioperatively after ORIF of mandibular fractures and treatments need to be adapted to these patients. Discrepancies of treatments to common guidelines may also be an independent predictor for treatment failure in patients without risk factors. Current treatment guidelines should be reevaluated concerning additional treatment strategies for patients with specific risk factors.
Keywords: mandibular fracture; revision surgery; complications; miniplates; reconstruction plates mandibular fracture; revision surgery; complications; miniplates; reconstruction plates

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MDPI and ACS Style

Steffen, C.; Welter, M.; Fischer, H.; Goedecke, M.; Doll, C.; Koerdt, S.; Kreutzer, K.; Heiland, M.; Rendenbach, C.; Voss, J.O. Revision Surgery with Refixation After Mandibular Fractures. Craniomaxillofac. Trauma Reconstr. 2024, 17, 214-224. https://doi.org/10.1177/19433875231179318

AMA Style

Steffen C, Welter M, Fischer H, Goedecke M, Doll C, Koerdt S, Kreutzer K, Heiland M, Rendenbach C, Voss JO. Revision Surgery with Refixation After Mandibular Fractures. Craniomaxillofacial Trauma & Reconstruction. 2024; 17(3):214-224. https://doi.org/10.1177/19433875231179318

Chicago/Turabian Style

Steffen, Claudius, Margrit Welter, Heilwig Fischer, Maximilian Goedecke, Christian Doll, Steffen Koerdt, Kilian Kreutzer, Max Heiland, Carsten Rendenbach, and Jan O. Voss. 2024. "Revision Surgery with Refixation After Mandibular Fractures" Craniomaxillofacial Trauma & Reconstruction 17, no. 3: 214-224. https://doi.org/10.1177/19433875231179318

APA Style

Steffen, C., Welter, M., Fischer, H., Goedecke, M., Doll, C., Koerdt, S., Kreutzer, K., Heiland, M., Rendenbach, C., & Voss, J. O. (2024). Revision Surgery with Refixation After Mandibular Fractures. Craniomaxillofacial Trauma & Reconstruction, 17(3), 214-224. https://doi.org/10.1177/19433875231179318

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