Prediction of Mandible Traumatic Osteomyelitis

Algirdas Lukosiunas, Gintautas Sabalys, Ricardas Kubilius

Summary

The purpose of the study was to establish the factors determining development of mandible traumatic osteomyelitis, and to design a method for prediction of the disease. 625 patients who had been treated for mandible traumatic osteomyelitis at KMUC Maxillofacial Surgery Clinic for the period of 1989 to 2001 were examined. The control group consisted of 200 patients whose mandible fractures healed up without any complications. The influence of every factor on the osteomyelitis etiology was estimated as a quantitative indicator, i.e. a risk coefficient (RC). The risk coefficient was calculated as the following: the frequency of the factor in per cents among osteomyelitis suffers was divided by the frequency of the factor among the patients of the control group. The higher than 1 the risk coefficient was, the bigger influence the factor had on the osteomyelitis development. The following factors were estimated to have the highest risk coefficients: carious teeth non-extracted from the fracture line (RC – 11.5), insufficient fixation of fractured (RC – 10.5), immune system disturbances (RC – 10.0), carious teeth extracted from the fracture line later than a week after the trauma (RC – 4.9), specialized treatment applied later than a week after the trauma (RC – 4.4), insufficient reposition of the fractured bones (RC – 3,7). An objective estimation of every quantitative factor gave a possibility to suggest a method for mandible traumatic osteomyelitis prediction. The possibility of traumatic mandible osteomyelitis development was estimated according to the sum total of risk coefficients of individual factors. If the sum total of risk coefficients was higher than 44.4, the possibility of osteomyelitis development was estimated to be 100%, while this sum was less than 21.5, the possibility of osteomyelitis reduced up to 1%.

Key words: mandible fractures, mandible traumatic osteomyelitis.

Address correspondence to Dr. A.Lukosiunas:
Dept.of Oral and Maxillofacial Surgery, 2 Eiveniu str., Kaunas, Lithuania.

Received: 02 02 2003

Accepted for publishing: 27 06 2003