The latest study from the Journal of Oral and Maxillofacial Surgery has confirmed the clinical gestalt of thousands of emergency physicians:
If a patient has a broken mandible, you will know within minutes — sometimes seconds, of meeting them exactly what series of events led to the fracture.
The study included males between the ages of 17 and 22.
Lead researcher Dr. K. Armah summarized the findings: “Essentially, if you encounter a patient in our study group with a mandible fracture and your initial impression is that they deserved it, you’re right. Save yourself the time it takes to collect an H&P or review of systems. They got their ass beat.”
Amazingly, the study had both retrospective and prospective components. With many patients study physicians were able to not only determine what happened, but what will probably happen again based on patient characteristics.
“The presence of any clothing item from Ed Hardy, Tapout or MMA seemed to be the greatest prognostic indicator of future mandible fractures, with an odds ratio of 2, 2.9 and 4, respectively.” Dr. K. Armah added.
Patients who were clearly intoxicated but admitting to “a beer”, arrived between midnight and 4:00 a.m. or who were accompanied by anyone who was not a patient yet made healthcare or food demands only enhanced the prognostic abilities of the physicians involved.
Sub-analysis also revealed pharmacologic implications of treating this patient population.
“It seems that no sedating or analgesic medications were required to fix the fractures. Most of these patients were so inebriated they had no idea what was happening inside of their mouths during the fixation. Aside from what appeared to be the occasional grunting quote from Rocky, these patients tolerated the procedure well and had almost no recollection of what occurred.”
Further, many of the patients self-reported having a ‘high pain tolerance’ after the procedure.”
The findings are currently being validated at every emergency department, everywhere.
