Healing of Mandibular Fracture Treated by Closed Reduction with Intermaxillary Fixation for Three Weeks

Abstract

This research aimed to study healing and complications of mandibular fracture treated by closed reduction with an intermaxillary fixation for three weeks and to compare means of maximum mouth opening distance at 4^th, 5^th, and 6^th weeks with standard maximum mouth opening distance. Patients with a mandibular fracture who came to oral and maxillofacial surgery department, Chonburi hospital between November 2017 and January 2019 and met the criteria were treated by closed reduction with intermaxillary fixation (IMF) for three weeks. After that, the IMF was cut but arch bars still had been remained, patients were taught to do jaw exercise. Infections, malocclusions and maximum mouth opening distances were measured weekly until the 6^th week. At 6^th week healing of mandibular fractures was measured, Healing and complication rates such as infection and malocclusion were calculated and the means of maximum mouth opening distance at 4^th, 5^th, and 6^th weeks were compared with standard maximum mouth opening distance using One Samples T-test.                                                                             

The results revealed that 20 patients were included in the study, 11males (55%) and 9 females (45%). The mean age of the subjects is 26.4+9.253 years (range from 15-51 years). 30 fracture sites were treated, and the most common fracture sites were the symphysis (43.33%) follow by condyle (26.67%) Healing was observed in19 subjects at 6^th week (95%) 95%confident interval of healing rate is 76.39-99.11%. No one had an infection or a malocclusion. The means of maximum mouth opening distance before (22.25+8.315 mm.) and at 4^th week after IMF (31.55+8.236 mm.) were significantly lower than standard maximum mouth opening distance (40 mm.), but the means of maximum mouth opening distance at 5^th (40.50+7.715 mm.)   and 6^th week after IMF (42.30+7.888 mm.) are no significant difference from the standard maximum mouth opening distance.

These findings indicate that the mandibular fractures treatment by closed reduction with an intermaxillary fixation for three weeks give a normal healing without complications in healthy adult patients age 15-51 years old. Patient compliance and hygiene care are important factor for success. For 3 weeks of IMF, the patient mouth opening returns to normal in 5 weeks after treatment with less effort.