Maxillofacial injury – a retrospective analysis of time lapse between injury and treatment
Date
2012-01-19
Authors
Porter, Michelle Isabella
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Abstract
Background: The sooner that a maxillofacial injury is treated the lower the complication
rate will be, and the more ideal the healing. Staff in the Division of Maxillofacial and Oral
Surgery at the Charlotte Maxeke Johannesburg Academic Hospital have an anecdotal belief
that facial fractures are treated about three weeks after injury. An extensive search showed
that no objective evidence on treatment times have been published in South Africa or
internationally. The current study was undertaken to provide evidence.
Objective: To undertake a clinical audit to examine seven time intervals from fracture
occurrence to patient discharge.
Methods: Data were recorded into a Microsoft Excel spreadsheet from the clinical records
of 725 patients with facial fractures in 2002, 2004 and 2006. These data were analysed using
SAS.
Results: The broad demographics of the 725 patients were 86% male and 14% female and
79% of fractures were due to interpersonal violence. For the total sample the mean times
±SD in days for the seven time intervals are fracture occurrence – hospital presentation
10.3±12.7, fracture occurrence – treatment 20.4±17.6, referral (n=333) – hospital
presentation 4.5±8.3, referral – treatment 14.6±15.6, hospital presentation – treatment
10.3±11.8, treatment – discharge 1.3±2.0, hospital presentation – discharge 11.7±12.8.
Statistically significant effects were noted for year of study for 6/7 time intervals while there
were significant associations with referral and race for one time interval each.
Conclusions: For this unique study no data exists for comparison. The results suggest that
that patients could reduce the time intervals from fracture occurrence to hospital
presentation and treatment by seeking definitive treatment earlier – possible reasons for
delay are mentioned in Chapter 4. From the side of MFOS clinicians, efficient referral for
specialist treatment and more staff could further reduce time to treatment.