Long-term complications following different treatment modalities for mandibular fractures

Abstract

Background: All the approaches for mandibular fracture treatment have their associated advantages and complications. The complications associated with treated mandibular fractures as listed in literature are found to be approximately in the range of 9% to 36 percent. Various complications seen after treating mandibular fractures can be attributed to the site of the fracture, type of fracture, displacement, peri-operative occlusion, contributing factors, and treatment chosen. Aims: The present trial was aimed at evaluating various long-term complications associated with different treatment procedures for managing mandibular fractures. Materials and Methods: 78 subjects were retrospectively analyzed within the age range of 19 years to 62 years with the mean age range of 42.4 years. The previous records of the patients were obtained from the previous hospital records for analyzing retrospectively. The patients managed either with open reduction and internal fixation or with closed reduction. Weekly follow-up was done for all the subjects for 6 weeks post-operatively to assess the complications. The collected data were subjected to statistical evaluation. Results: Fractures of parasymphysis and ZMC were most commonly seen in the study population which were 30.26% (n=23) and 57.69% (n=45) respectively. This was followed by fractures of the mandibular condyle and mandibular angle with the relative percentage of 29.48% (n=.22) and 21.79% (n=17) respectively. The most common etiological factor associated with the mandibular fracture was road traffic accident with 66.66% (n=52) followed by the fall from some height which was seen in 15.38% of subjects (n=12), assault (n=6), and sports injury in 6.41% (n=5). The most common complaint reported by the study subjects post-operatively was malocclusion in 21.79% of study subjects. Among various malocclusions, open-bite was most commonly seen. The next common complication was paresthesia of the lower lip which was reported as a lack of sensitivity in 8.97% of subjects (n=7). Less commonly mandibular deviation/deflection, pain in TMJ, infection, and malunion was also noticed. Conclusion: As per the present study, a total of 47.43% (n=37) subjects presented with either major or minor complications. The most common malocclusion was open bite which was frequently seen with displaced bilateral condylar fractures. No significant difference in the postoperative complications was seen with either closed treatment or open treatment of fractured mandible.

Keywords: Complications, Malocclusion, Mandibular Fracture, Retrospective, Road Traffic Accidents