Assessment of Treatment Modalities for Mandibular Fracture in Patients with Compromised Pulmonary Function

Background Mandibular fractures are among the most common facial injuries managed by oral and maxillofacial surgeons, with road traffic accidents as the leading cause in many developing countries. While Open Reduction and Internal Fixation (ORIF) and Closed Reduction with Maxillomandibular Fixation (MMF) are both effective treatment modalities, their differential impacts on pulmonary function remain understudied. The objective of the study was to compare the effects of ORIF and MMF on pulmonary function in patients with isolated mandibular fractures. Methods A randomised comparative longitudinal study was conducted among 66 patients with isolated mandibular fractures. Participants were equally assigned to Open Reduction and Internal Fixation (group 1) and Closed Reduction with Maxillomandibular Fixation (group 2) groups. Preoperative and postoperative pulmonary function tests were carried out at different intervals using standard protocols. Data were analysed using SPSS version 26 with significance set at p < 0.05. Results Both groups showed comparable baseline pulmonary function. However, group 2 patients experienced a significant decline in pulmonary parameters at 24 hours, 1 week, and 2 weeks postoperatively. Although recovery was observed by the 4th and 6th weeks, Forced Vital Capacity (FVC) remained lower in group 2, while FEV₁/FVC was significantly higher. One week after MMF removal, Peak Expiratory Flow Rate (PEFR) and FEV₁/FVC values rebounded significantly in the MMF (group 2). Conclusion Even though MMF remains a viable, low-cost option of managing mandibular fractures, ORIF is associated with less respiratory impairment and may be better suited for patients at risk of pulmonary complications. These findings also underscore the importance of individualised treatment planning.