2017-18 HSC Section 3 Green Book

ORAL AND MAXILLOFACIAL SURGERY e8 Kotrashetti, Lingaraj and Khurana

April 2013

Table I. Distribution of study samples according to groups and pain at 3 and 6 months’ follow-up

3 mo

6 mo

Group

Present

Absent

Present

Absent

Group I: closed reduction Group II: open reduction

4 (33%) 0 (0%)

8 (66%)

4 (33%) 0 (0%)

8 (66%)

10 (100%)

10 (100%)

Yates corrected chi-square 2.1411; P .1430

Yates corrected chi-square 2.1411; P .1430

Table II. Distribution of study samples according to groups and occlusion at 3 and 6 months’ follow-up

3 mo

6 mo

Group

Deranged

Fine

Deranged

Fine

Group I: closed reduction Group II: open reduction

2 (16.7%)

10 (83.3%) 10 (100%)

1 (8.3%)

11 (91.7%) 10 (100%)

0 (0%)

0 (0%)

Yates corrected chi-square .3710; P .5420

Yates corrected chi-square .0003; P .9997

Table III. Distribution of study samples according to groups and mandibular movements at 3 and 6 months’ follow-up

3 mo

6 mo

Groups

Restricted

Normal

Restricted

Normal

Group I: closed reduction Group II: open reduction

4 (33%) 0 (0%)

8 (66%)

4 (33%) 0 (0%)

8 (66%)

10 (100%)

10 (100%)

Yates corrected chi-square 2.1411; P .1430

Yates corrected chi-square 2.1411; P .1430

evaluated for occlusion, pain, movements (protrusive, laterospective-right, -left), maximal mouth opening, de- viation, facial nerve function, TMJ clicking sounds, ear sensitivity, and scar. Radiographic assessment was done using orthopantomogram (OPG), lateral cephalo- gram, and posteroanterior (PA) mandible. The fol- low-up was done at the intervals of 3 and 6 months. Open reduction was carried out using retromandibu- lar approach followed by fixation with titanium mini- plates and 2 6 mm titanium screws. Closed reduction was achieved using arch bars fol- lowed by intermaxillary fixation (IMF) using elastics for the first 2-3 days to guide the occlusion and then replacing them by wires to achieve rigid IMF. This was maintained for 3-4 weeks. The fractures present at other sites of the mandible, in either of the groups, were treated by internal rigid fixation. Nine such cases were included in group I and 7 in group II. All of these fractures present at other sites of the mandible were unilateral. RESULTS Table I presents the distribution of study samples ac- cording to groups and pain at 3 and 6 months’ follow- up. When comparing the groups, pain was present in 33% of the cases treated by closed reduction at both 3 and 6 months of follow-up, whereas none of the pa- tients presented with the complaint of pain among the

open reduction group. But results were found to be statistically insignificant when 2 test was done. Table II presents the distribution of study samples according to groups and occlusion at 3 and 6 months’ follow-up. Occlusion was deranged in 16.7% of the pa- tients in group I at 3 months’ follow-up and in 8.3% at 6 months’ follow-up. Occlusion was found to be fine in all of the patients treated by open reduction. 2 test showed significant results at 6 months’ follow-up ( 2 .0003). Table III presents the distribution of study samples according to groups and mandibular movements at 3 and 6 months’ follow-up. When comparing the man- dibular movements, they were restricted in 33% of the cases treated by closed reduction at both 3 and 6 months’ follow-up, whereas none of the patients showed restriction in movements of the mandible pain among the open reduction group. But results were found to be statis- tically insignificant when 2 test was done. Table IV presents the distribution of study samples according to groups and maximal interincisal opening at 3 and 6 months’ follow-up. Maximal interincisal opening was achieved in only 41.7% of the cases at 3 months’ follow-up and 58.3% at 6 months’ follow-up in group I, whereas in group II, 80% of the patients could achieve maximal interincisal opening at 3 months’ follow-up and 90% patients at 6 months. But results were found to be statistically insignificant when 2 test was done.

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