Published Paper Details:

Mandibular fractures are the most common among facial skeleton fractures. The causes of mandibular fractures include falls, interpersonal violence, motor vehicle accidents, pathology and iatrogenic during to other removal. Assaults are the most common cause of isolated mandible fracture. The available treatment strategies for mandibular sub condylar fracture are open or closed reduction with maxillomandibular fixation (MMF), conservative treatment that includes observation, analgesics, anti-inflammatory, soft diet and early physical therapy exercise. Closed reduction of mandibular fracture with MMF can adversely affect bone, muscle, synovial joint and periarticular connective tissues. The changes in muscle of mastication system have been documented following immobilization of mandible. The Cortical and trabecular thinning, vascular distention and increased osteoclastic activity have been described following joint immobilization. Clinical bone union in adults occurs within 4to 6 weeks. But unwanted complications after close or open reduction with MMF in fracture mandible includes bony deformities, trigeminal nerve injury, facial nerve injury, TMJ ankylosis or decrease mouth opening, changes in musculature including muscle atrophy, change in length and function with dental occlusion affection or temporomandibular joint disorder. Post fractur early Physical therapy rehabilitation is essential for achieving good outcomes that include restoration of pre occlusion, restoration of mouth opening, pain free mouth opening, full range of mandibular excursion, restoration of facial and mandibular symmetry. Condylar fractures lead to violation of articular space, inflammation and hemarthrosis which increases fibrous matrix formation and reduces mandibular movements. Adhesion of the coronoid process and hypertrophy around it, or fibrosis of the temporalis muscle, can be considered as other causes of pseudo ankylosis. The true ankylosis which results from fibrous adhesions or bony fusion is also commonly caused by trauma. The mandibular movement limitations itself may lead to a change in the synovial membrane and reduction in joint lubrication. The muscle weakness and fibrosis may lead to further jaw movement limitation and increased pain.