Clinical Outcomes in Mandibular Fracture at Symphysis and Parasymphysis Region with Miniplates under Local Anesthesia in Systemic Compromised Patients

Objective: The objective of this study is to determine the clinical and functional stability and efficacy in the management of mandibular fractures in systemically compromised patients treated under local anesthesia. Place and Duration: This prospective study was conducted in the department of Oral and Maxillofacial Surgery, Bibi Aseefa Dental College, Shaheed Mohtarma Benazir Bhutto Medical University, Larkana from august 2013 to august 2014. Materials and Methods: Total recorded patients were 10 in number; these patients were selected in accordance to selection criteria. Mechanism of trauma was recorded. Eight (80%) patient had fractured mandible caused by road traffic accident, one suffered due to assault and one had a history of fall. Under supervision of qualified anesthetist, Procedures were carried out with local anesthesia plus sedation (Diazepam 5mg/ml) and local infiltration of lignocaine 2% with adrenaline 1:80000 (Max: 7.5mg/kg) for hemostasis. All fractures were treated by Open Reduction and Internal Fixation (ORIF) via intra-oral surgical approach. Results: Majority of the patients were males 8 (80%) and 2 (20%) were female. Patients were followed for a period of 3 months at the interval of 1 week, 2 weeks, 4 weeks, 8 weeks, and 3 months for wound dehiscence, infection, segmental mobility, postoperative occlusion, significant postoperative complications, and radiological evaluation of reduction, and fixation. Treatment outcomes were evaluated keeping in consideration of post operative complication, functional and aesthetic outcomes. Postoperative complication was minimum, only one (1%) developed infection. A value of P less than .05 was considered statistically significant. Conclusion: Treatment of mandibular fracture at symphysis and parasymphysis region under local anesthesia with complete resuscitation facilities is a better option for medically compromised patients.