A clinical assessment of postoperative complications of mandibular fractures using Mandibular Injury Severity Score at K. R. Hospital, Mysore

Introduction: Among the facial injury, the mandibular fractures represent a substantial portion of surgical case load to trauma centers. Management of this common injury varies greatly and is still driven by expert opinion or empirical data. Scientific study of mandible fractures and their treatment has been hampered by the lack of an injury cataloging system that allows a disciplined, systematic aggregation of collective clinical experiences. Materials and Methods: A prospective study was conducted in the Department of Dentistry, Mysore Medical College and Research Institute, Karnataka, Mysore, India. Subjects selected were above 16 years of age with isolated mandibular fractures who were eligible to undergo treatment. A total of 50 patients were divided into two groups, closed and open reduction, each having 25 subjects. Each individual case was evaluated for FLOSID components separately. Mandibular Injury Severity Score (MISS) was assigned based on summated results of FLOSID components. Obtained complication scores and MISS were correlated statistically using Spearman’s correlation coefficient among the different groups. Results: On comparison between the two groups, open reduction and internal fixation (ORIF) and maxillomandibular fixation (MMF), statistical analysis using Mann–Whitney U test showed mean and median values for the ORIF group as 6.52 and 5 (3–11), respectively whereas mean (SD) and median values in the MMF group as 5.52 (3.31) and 5 (3–3.5), respectively. There was proportional increase in both MISS and complication score. The aforementioned analysis indicates that MISS is a predictable parameter in assessing postoperative complications of mandibular fracture and also in predicting the complication outcomes in clinical situation. Conclusion: This study concludes that the higher the MISS, the higher the rate of complications in groups treated with ORIF. MISS however did not correlate much with groups treated using closed method. FLOSID taxonomy predicted the exact details of cases and helped arriving at MISSs, of individual cases with complication score to help the clinician to arrive and predict postoperative events, and to adopt proper treatment plan for individual cases, to minimize the complication score as low as possible, for the benefit patients with Maxillofacial trauma.