A comparative study of the outcomes of mandibular fractures treated with and without per and post operativemaxillo-mandibular fixation.

Abstract

Background: Mandible being prominent and mobile gets fractured commonly. Fracture healing is important for restoring chewing abilities and
aesthetic appearance. The fracture healing in mandibles is painful and maintaining reduction is difficult due to the action of various the muscles
attached to mandible. There are few reports about fixing mandible fracture with intraoperative manual maintenance of occlusion without applying
traditional arch bars and MMF.Aims: to study the outcome following rigid fixation of mandibular fractures without per operative or post
operativemaxillo- mandibular fixation and immediate mobilisation.Materials and methods: This is a prospective study conducted in the
Department of Plastic and Reconstructive Surgery in a Government tertiary care centre over a duration of 18 months in 30 patients with anterior
mandibular fractures in which each 15 patients belonging to Group I and Group 2 received ORIF with MMF.Results: Mean time of fixation in
Group 1 (ORIF without MMF) was 22.27 minutes whereas in Group 2 (ORIF with MMF) it was 38 minutes which is statistically significant.
There was statistically no significant difference in occlusal disturbances in both groups compared in the study. There was no significant
difference after fixation with or without MMF in stability of fracture segment.There was no statistically significant difference between both
groups in terms of neurosensory deficits and masticatory efficiency. Patients of both groups were kept on soft diet for a period of 1 month. Mouth
opening in patients in both the groups showed a gradual recovery till 1 month after which it stabilized. There was gradual decrease in pain in
patients of both groups.Conclusion: Maxillomandibulary fixation reduces the operative time and aids in early mobilisation and better intake of
diet. Mandible fractures can be managed by Open reduction and internal fixation with intra operative manual maintenance of occlusion and
satisfactory results can be obtained.