Changes in C-reactive protein associated with surgical treatment of mandibular fractures

Abstract

C-reactive protein (CRP) levels were determined in 80 patients (67 male, 13 female), each with a single mandibular fracture in either the symphysis, body, or angle region. All patients underwent osteosynthesis (63 with rigid plate fixation following the AO/ASIF principle, 17 with miniplates). C-reactive protein levels were measured on admission and daily during hospitalization. Preoperative CRP levels (mean, 28.5 mg/L) varied according to the time that had elapsed since injury. After surgery, there was always an increase in CRP level. The level reached its maximum (mean, 73.2 mg/L) on the second day after operation. Postoperative CRP levels were significantly influenced by the time between trauma and surgery. Significant differences were also observed with different types of fixation. Fixation with rigid plates was associated with smaller increases in CRP level than was fixation with miniplates. The location of the fracture, associated condylar fractures, the use of maxillomandibular fixation, the presence or absence of a tooth at the fracture site, and the surgical approach did not affect the CRP levels. The significance of CRP measurement for interpretation of postoperative situations is discussed and examples of cases in which there was infection are described.