Physiotherapy Maneuver is Critical to Recover Mouth Openings in Pediatric Trauma

Publication date: Available online 4 August 2016
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Ghada Amin Khalifa, Naglaa Shawki El-Kilani, Hanan Mohmed Shokier
PurposeA restricted mouth opening (MO) is predominantly a complication of maxillofacial traumas in pediatric patients that develops in 4–26.2% of cases. The purpose of this study was to quantitatively investigate the influence of patients' demographic data, fracture characteristics, and the regular vigorous physiotherapy, either voluntary or forcible MO, on recovery of a post-traumatic restricted MO in pediatric patients.Material and methodsA prospective cohort study was performed in pediatric patients with maxillofacial injuries who were referred to Al-Zahraa and El-Fayoum Hospitals from 2013 to 2015. The predictable variables were patients' demographic data, fracture characteristics, and regular vigorous physiotherapy. The patients were treated by closed technique. MO measurements were the clinical outcome variables, and were recorded at the first week, then monthly up to 12 months. The regular vigorous physiotherapy was performed until patients return their MO. The data were tabulated and statistically analyzed.ResultsEighty-six patients were enrolled in the study. Males were predominant. Falls were the most common cause of fractures. Condylar fractures had the highest incidence. The restricted MO occurred in 81 cases. The results showed no interaction between MO recovery and the age, gender, etiology, and site of the fracture. After physiotherapy, patients returned their MO at the fourth month, and then the measurements had fixed normal values at the sixth month. The recovery rate was non-linear, with faster improvement in months closest to injuries.ConclusionThe physiotherapy is more critical in recovery of MO and prevention of bony ankylosis than patients' data and fractures characteristics in pediatric traumas. The voluntary mouth exercises are highly advocated to be done even there are no fractures. The forcible MO is mandatory to recover restricted MO. It should be performed under close supervision of the patients' surgeons with parents' motivation to get their cooperation for at least 6 months.



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