Undiagnosed mandibular condylar fractures causing temporomandibular joint ankylosis: A problem in northern India.
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Date
2014-09
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Abstract
Background.Temporomandibular joint (TMJ) ankylosis due
to undiagnosed condylar fractures has a high incidence in India
compared to western countries. We evaluated the demographics,
injury pattern, hospital reporting and referral pattern of
undiagnosed condylar fractures complicating TMJ ankylosis in
northern India.
Methods.We did a retrospective analysis by retrieving medical
records of patients with post-traumatic TMJ ankylosis reporting to
the Department of Oral and Maxillofacial Surgery, All India Institute
of Medical Sciences between 1July 2012 and 30June 2013.
Results. Of 90 patients with post-traumatic TMJ ankylosis,
74 (82.2%) resided in rural areas. Sixty-three (70%) patients
were from the states of Uttar Pradesh, Bihar and Jharkhand. Only
8.8% had higher education and 10% had an annual income of
more than `2 lakh. In 69 (84.4%) patients, fall was the
aetiological factor. Primary health centres (42%) and private
clinics (20.5%) received the major share of patients immediately
following injury. Few patients (19.3%) had some radiographic
examination done and only 17% were referred by the primary
healthcare provider. Of those referred only 3 were examined by
a dental practitioner. Only 10% of all were diagnosed with
condylar fractures.
Conclusion.Patients with TMJ ankylosis presenting to us have
poor literacy and income levels. A missed diagnosis of condylar
fractures by rural healthcare providers contributes to its high
incidence in India. Improving awareness of clinicians and improved
rural healthcare infrastructure can help prevent this complication.
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Shakil Ahmed Nagori, Anson Jose, Ongkila Bhutia, Ajoy Roychoudhury. Undiagnosed mandibular condylar fractures causing temporomandibular joint ankylosis: A problem in northern India. National Medical Journal of India. 2014 Sept-Oct ; 27(5): 251-255.