Comparative postoperative infection rates in midfacial trauma using intermaxillary fixation, wire fixation, and rigid internal fixation implants.

The use of rigid internal fixation implants in the repair of midfacial fractures requires more extensive bone exposure, soft-tissue manipulation, and operative time. We wished to determine the relative contribution of this method of repair to postoperative infection rates. Midfacial trauma cases occurring between the years 1984 and 1991 at the University of Iowa Hospitals and Clinics, Iowa City, were reviewed. Patients were grouped according to method of repair (intermaxillary fixation, open reduction with wire fixation, or open reduction with rigid internal fixation plates). Postoperative infection data (wound infections, sinusitis, etc) were obtained by chart review and telephone interview. Minimum follow-up for inclusion in the study was 3 months, with an average follow-up for all groups of 28.8 months. We found no significant difference in the rate, or the type, of postoperative infections in all three groups. We conclude that rigid internal fixation implants do not contribute increased postoperative infection rates in midfacial trauma.