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

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