Does infection of a mandibular fracture lead to the development of chronic pain syndrome? Assessment of patient treatment results based on functional indicators, standardized questionnaires and quality of life assessment

Background: Fractures of the mandible are among the most common injuries to the bones of the facial skeleton and are associated with a relatively high incidence of complications, particularly purulent-inflammatory conditions, especially when treatment is delayed. These complications and surgical interventions can damage the masticatory muscles, disrupt their physiological balance, impair mandibular movement and contribute to pain syndrome development. This study aimed to investigate the dynamics of pain severity, the restoration of stomatognathic apparatus function following purulent-inflammatory complications of mandibular fractures and their impact on patients’ quality of life. Methods: We assessed the data of 15 patients with mandibular fractures without fragment displacement but complicated by purulent-inflammatory processes. Surgical intervention was combined with intermaxillary immobilization for four weeks, followed by myogymnastic exercises during rehabilitation. Mandibular movement amplitude was measured in three planes and surveys were conducted. Pain syndrome was assessed using the Visual Analog Scale and McGill Pain Questionnaire, and their psycho-emotional status was evaluated using the Spielberger-Hanin Anxiety Scale and Beck Depression Inventory. Quality of life was measured using the Medical Outcomes Study-Short Form questionnaire (SF-36). Assessments were performed on the fourth postoperative day, immediately after splint removal,and at one, six and twelve months post-operation. Mandibular mobility was also measured seven and fourteen days post-splint removal. Results: The results were then compared with a group of healthy volunteers. Over one year of observation, we found that all functional and psychometric parameters of the patients remained significantly lower than those of the healthy volunteer group, and these deficits predisposed patients to muscle dysfunction and negatively impacted their quality of life. Conclusions: Therefore, continued research is essential to develop effective treatment and rehabilitation strategies for this patient population.

Fracture; Mandibular mobility; Pain syndrome; Inflammatory complication; Functional recovery

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