CRANIOMAXILLOFACIAL TRAUMA J Oral Maxillofac Surg 69:2191-2197, 2011 Mandibular Fracture Severity and Patient Health Status Are Associated With Postoperative Inflammatory Complications Paul E. Gordon, DMD, MD,* Matthew E. Lawler, BS,† Leonard B. Kaban, DMD, MD,‡ and Thomas B. Dodson, DMD, MPH,§ Purpose: To identify risk factors associated with postoperative inflammatory complications (POICs) after treatment of mandibular fractures. Patients and Methods: The investigators designed a case– control study and enrolled a sample of patients treated for mandibular fractures at Massachusetts General Hospital between August 2004 and January 2010. Subjects who developed POICs after fracture management were categorized as cases. A POIC was defined as 1) recurrent swelling, fever, increased pain, or trismus; 2) wound dehiscence with purulent drainage; 3) exposed or infected hardware; 4) abscess formation; 5) radiographic evidence of osteomyelitis; and/or 6) presence of a fistula. Controls had no complications. For each case, 2 controls were selected. Predictor variables were categorized into the following sets: demographic, fracture-specific, and periopera- tive. Bivariate and multiple logistic regression analyses were used to identify factors associated with POICs. Results: During the study interval, 575 subjects with mandible fractures were evaluated and treated. The study sample consisted of 44 cases and 88 controls. In the multiple regression model, an increasing Mandibular Injury Severity Score (odds ratio = 1.4; 95% confidence interval 1.2-1.6) and a positive medical history (odds ratio = 1.4; 95% confidence interval 1.03-1.8) were significantly (P  .05) associated with an increased risk for a POIC. Conclusion: Fracture severity assessed using the Mandibular Injury Severity Score and pre-existing medical problems were associated with increased risk for postoperative inflammatory complications following treatment of mandibular fractures. © 2011 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 69:2191-2197, 2011 Post-operative inflammatory complications (POICs) after mandible fractures are reported to occur with frequencies up to 30%. 1-7 Patients with POICs often require multiple surgical procedures and extended lengths of hospital stay (LOS), significantly increas- ing health care expenses. Given the high frequency Received from the Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine, Boston, MA. *Resident-in-training. †DMD Candidate, AO/Synthes Student Research Fellow in Pedi- atric Oral and Maxillofacial Surgery. ‡Chief and Walter C. Guralnick Professor of Oral and Maxillofa- cial Surgery. §Visiting Oral and Maxillofacial Surgeon; Director, Center for Applied Clinical Investigation; and Professor of Oral and Maxillofacial Surgery. This study was supported by the Massachusetts General Hospital Department of Oral and Maxillofacial Surgery Education and Re- search Fund and Center for Applied Clinical Investigation and the Massachusetts General Physicians Organization. Address correspondence and reprint requests to Dr Dodson: Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, WACC230, Boston, MA; e-mail: tbdodson@ partners.org © 2011 American Association of Oral and Maxillofacial Surgeons 0278-2391/11/6908-0025$36.00/0 doi:10.1016/j.joms.2011.03.071 2191