Clinical analysis of changes in function of the temporomandibular joint after open reduction and internal fixation of mandible fracture

Abstract

Aim: The aim was to evaluate the change in function of temporomandibular joint after open reduction and internal fixation of mandible fracture. Materials and Methods: This study was conducted on fifty patients with mandible fractures (excluding condyle fractures) that were treated by open reduction and internal fixation and were followed up to 12-24 months postoperatively. Fifty normal individuals of the same age group with fracture patients were randomly selected. Range of motion of mandible was recorded in both the groups and statistically analyzed using SPSS software. One-way ANOVA and ' t ' tests were used as appropriate. Results: In the fracture group, mean inter-incisal opening, lateral excursion and protrusion in millimeters were 37.16 ± 1.07; 5.34 ± 0.37 and 5.38 ± 0.30, respectively, whereas mean interincisal opening, lateral excursion and protrusion in millimeters were 46.9 ± 2.88, 8.98 ± 0.89 and 7.46 ± 0.83, respectively, in the control group. In the fracture group, 14 had click on opening and 18 developed crepitation on joint movement where as in the control group, 6 had click and 6 had crepitation on joint movement. Similarly 22 patients in the fracture group developed deviation on opening mouth compared to 10 in the control group. Conclusion: Range of motion of mandible is decreased in patients operated for mandibular fractures. Deviation on opening and joint sounds especially crepitus are higher in operated patients. These patients require aggressive mouth opening exercises and regular evaluation in a post operative period.