{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T19:10:01Z","timestamp":1787685001698,"version":"build-2784847793"},"reference-count":30,"publisher":"MDPI AG","license":[{"start":{"date-parts":[[2023,6,5]],"date-time":"2023-06-05T00:00:00Z","timestamp":1685923200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Dr Jan Oliver Voss and Dr Heilwig Fischer are participants in the BIH Charit\u00e9 Clinician Scientist Program funded by Charit\u00e9 - Universit\u00e4tmedizin Berlin and Berlin Institute of Health at Charit\u00e9"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Craniomaxillofacial Trauma &amp; Reconstruction"],"abstract":"<jats:sec><jats:title>Study Design<\/jats:title><jats:p> Retrospective, descriptive observational study. <\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p> The need for revision surgery after mandibular fractures is an indicator for severe postoperative complications. This study aimed to characterise this patient cohort, describe solutions to deal with complications and evaluate treatment quality as a risk variable for complications. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> Patients with revision surgery with refixation after open reduction and internal fixation (ORIF) of a mandible fracture were included. Patient- and therapy-specific information were assessed together with postoperative complications. The quality of fixation was evaluated individually by 6 specialists. Interobserver agreement was analysed using Fleiss\u2019 kappa. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Out of 630 patients, inclusion criteria were met by 17 patients (14 male, 3 female) with an average age of 43.3 (\u00b115.5)\u00a0years. Complications at the mandible body\/angle\/symphysis led to refixation in all cases. Main indications for refixation were osteomyelitis (52.9%) or pseudarthrosis (41.2%). Risk factors were drug-related immune suppression, local infection or substance abuse (nicotine, alcohol or drugs). Six patients did not present any of these predictors. Of these, treatment of 4 patients was rated as not in accordance to the AO principles. The interrater reliability of treatment quality assessments was .239. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p> Patients with risk factors need to be carefully observed perioperatively after ORIF of mandibular fractures and treatments need to be adapted to these patients. Discrepancies of treatments to common guidelines may also be an independent predictor for treatment failure in patients without risk factors. Current treatment guidelines should be re-evaluated concerning additional treatment strategies for patients with specific risk factors. <\/jats:p><\/jats:sec>","DOI":"10.1177\/19433875231179318","type":"journal-article","created":{"date-parts":[[2023,6,5]],"date-time":"2023-06-05T13:08:30Z","timestamp":1685970510000},"page":"194338752311793","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Revision Surgery With Refixation After Mandibular Fractures"],"prefix":"10.3390","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4221-4878","authenticated-orcid":false,"given":"Claudius","family":"Steffen","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margrit","family":"Welter","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heilwig","family":"Fischer","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Berlin, Germany"},{"name":"Center for Musculoskeletal Surgery, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Berlin, Germany"},{"name":"BIH Charit\u00e9 Clinician Scientist Program, BIH Biomedical Innovation Academy, Berlin Institute of Health at Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"Goedecke","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Berlin, 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Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4987-2913","authenticated-orcid":false,"given":"Max","family":"Heiland","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carsten","family":"Rendenbach","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1760-2599","authenticated-orcid":false,"given":"Jan O.","family":"Voss","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Berlin, Germany"},{"name":"BIH Charit\u00e9 Clinician Scientist Program, BIH Biomedical 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