Effect of Occupational Therapy Intervention Inpost-operative Mandibular Fractures - A Retrospective Study

Arti Yadav,Ashwini Chauhan,Vaijanti Jain

doi:10.11648/j.cmr.20211002.14

Abstract

Aim: To find the effectiveness of Occupational therapy intervention in post operative mandibular fracture patients. Objective: To improve mouth opening and reduce jaw deviations (temporomandibular joint mobility). Study design: A Retrospective study. Study setting: OPD of Occupational Therapy Department In Seth G. S. Medical College, KEM Hospital, Parel, Mumbai -400012, India. Methodology: Data was retrieved from Occupational therapy department records for the last one and half years i.e from july 2019 to jan 2021. In the said period around 33 operated mandibular fractures patients had been referred to Occupational therapy dept for therapy. Out of which only 20 patients followed up. Data of these 20 mandibular fractures patients were analysed. Inclusion criteria, Both males and females, Age group 20-60 years, Operated for mandibular fractures in period July 2019 – January 2021 who were referred to occupational therapy department for therapeutic intervention. Exclusion criteria: Incomplete data, Patients who have not followed up for second visit also. Outcome measures – Mouth opening with a tape measure at 1st, 3rd and 5th week respectively. All these data was already available in Occupationa therapy department records and there was no patient contact at all. Hence waiver of consent was asked for. Results: Statistical analysis (paired t-test) was used to assess the significance of difference. The calculated t value for mouth opening measurements was 17.1850 which was much much higher than the tabular t value at P=0.001, which means the increase in post treatment mouth opening measurements is just not by chance but it’s extremely significant at p= 0.001. The pre and post photograph of the patients showed a difference in jaw deviation angle too while opening mouth. The above results showed the treatment proved to be effective. Conclusion: The Occupation therapy intervention in post-operative mandibular fracture patients proved to be effective in improving mouth opening measurements and jaw deviations.

Highlights

Mandibular fracture known as jaw fracture, is a breach in the continuity of the mandibular bone
Out of total 33 patients referred to occupational therapy department only 20 patients continued with the therapeutic intervention and remaining 13 patients just came for the first time and never followed up later on
The calculated t value for mouth opening measurements was 17.1850 which was much much higher than the tabular t value at P=0.001, which means the increase in post treatment mouth opening measurements is just not by chance but it’s extremely significant at p=0.001

Summary

Introduction

Mandibular fracture known as jaw fracture, is a breach in the continuity of the mandibular bone. According to a study done in North India in 2018 consisting of 1015 individuals showed that the most common anatomic site for mandibular fracture is parasymphyseal region (40.3%), followed by angle (28.8%), condyle (27.6%) andsymphysis (12.5%) of mandible. The coronoid process of mandible (4.3%) was least involved in mandibular fracture. Males (30.8%) were more prone to mandibular fractures than females (15.7%) [1, 2]. The commonest etiology for mandibular fractures is trauma followed by some rare etiologies like osteonecrosis or tumor. The symptoms frequently described by patients following mandibular fractures are pain and the feeling that teeth no longer correctly meet (traumatic malocclusion or disocclusion). Management of mandibular fracture can be conservative or operative (open or closed reduction with internal fixation). External fixation can be Vaijanti Jain et al.: Effect of Occupational Therapy Intervention Inpost-operative Mandibular

Methods

Results

Discussion

Conclusion