The journal of trauma and acute care surgery
October 5, 2026 · via Europe PMC
Early fixation of traumatic mandible fractures is associated with decreased morbidity and resource utilization.
Yala LI, Zakhary B, Dhillon NK, Coimbra R.
AI summary — for doctors, generated from the abstract only
Fixing isolated mandible fractures within about 40 hours of admission was associated with fewer in-hospital complications and less ventilator time than later fixation.
What was studied
Retrospective analysis of adults with closed mandible fractures treated surgically in the Trauma Quality Improvement Program database (2017-2023). An ROC curve picked a data-driven cutoff for early versus delayed fixation, and outcomes were compared with multivariable regression.
Key findings
- ROC analysis proposed 40 hours as the data-driven time to fixation
- Delayed fixation had a higher composite complication rate (4.1% vs. 1.5%)
- The conclusion states that repair within 40 hours was linked to shorter mechanical ventilation, though the exact figures are cut off in the abstract
Clinical relevance
Suggests that prompt repair of isolated mandible fractures may reduce morbidity, challenging the prior view that timing does not matter. It may inform operating room scheduling for these injuries.
Who should care
Limitations
Retrospective registry design (Level III) with an exploratory, data-derived cutoff, so confounding and selection effects are possible. The abstract is truncated after the complication rates (p values and remaining results are missing).
Earlier fixation, within roughly 40 hours, looks favorable, but the association needs prospective confirmation.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
There is no clear guidance on when isolated mandibular fractures should undergo surgical fixation. Multiple studies have assessed the timing of mandibular fracture repair, with a consensus that earlier repair does not change outcomes. We aimed to challenge this consensus and identify a data-driven time for surgical fixation. We hypothesized that delayed fixation would be associated with worse outcomes.
Methods
Data on adult patients with closed mandible fractures who underwent surgical fixation were abstracted from the Trauma Quality Improvement Program database from 2017 to 2023. Patients with prehospital cardiac arrest, Abbreviated Injury Scale >2 in other body regions, interfacility transfers, deaths, and those discharged from the emergency room were excluded from analysis. The primary outcome was a composite variable of in-hospital complications. The secondary outcome was prolonged mechanical ventilation. A receiver operating characteristic curve was generated to determine a data-driven timing of surgical fixation based on observed differences in the primary outcome. Patients who underwent fixation before and after this defined time were grouped as "early" or "delayed," respectively. Statistical analyses used to compare outcomes between the groups included multivariable logistic regression and negative binomial regression.
Results
Receiver operating characteristic analysis identified 40 hours as the proposed data-driven time to fixation. Delayed fixation was associated with a higher composite complication rate (4.1% vs. 1.5%, p < 0.001) and independently associated with a two-fold increase in overall complications (adjusted odds ratio, 2.31; 95% CI, 1.90-2.79, p < 0.001). The negative binomial generalized linear model also identified delayed fixation as a risk factor for prolonged mechanical ventilation (incidence rate ratio, 1.42; 95% CI, 1.26-1.61, p < 0.001).
Conclusions
The proposed data-driven timing for fixation in traumatic mandibular fractures is within the first 40 hours from admission. Repair within this time frame is associated with fewer complications and shorter duration of mechanical ventilation. (J Trauma Acute Care Surg. 2026;00: 000-000 Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved.).
Level of evidence
Therapeutic/Care Management; Level III.
DOI
10.1097/ta.0000000000005196
PMID
42832397
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
Want more like this?
Browse more from the feed. A free account unlocks the full feed, saving and communities.
Back to the research feed