Facial Trauma Management During the Coronavirus Disease 2019 Pandemic

Importance:Facial trauma is managed with open or closed treatment modalities; however, the impact of the coronavirus disease 2019 (COVID-19) pandemic on facial trauma management remains unclear. Objective:To determine whether the management of facial trauma varied during the COVID-19 pandemic. Design Setting, Participants:A retrospective review of 127 adults at The R Adams Cowley Shock Trauma Center at the University of Maryland between March 2019 and March 2021. Adults were stratified into pre-COVID (before March 2020) and post-COVID groups. Main Outcomes and Measures:Open reduction internal fixation alone, maxillomandibular fixation (MMF) alone, Open reduction internal fixation and MMF, and closed reduction. Results:Of the 127 patients, 66 were treated pre-COVID (52%) and 61 post-COVID (48%). While the prevalence of mandible fractures did not differ (pre-COVID, n = 39, 59%; post-COVID, n = 42, 69%; P = 0.33), the use of MMF alone decreased (pre-COVID, n = 9, 23%; post-COVID, n = 1, 2%; P = 0.005). In contrast, while the prevalence of displaced nasal bone fractures decreased (pre-COVID, n = 21, 32%; post-COVID, n = 4, 7%; P = 0.0007), management with closed reduction did not differ (pre-COVID, n = 23, 96%; post-COVID, n = 11, 85%; P = 0.27). Conclusions and Relevance:Although the clinical characteristics of patients with facial fractures did not differ during the COVID-19 pandemic, the use of MMF for mandible fractures changed significantly.