EFFECT OF CORTICOSTEROID ON POST-OPERATIVE PAIN AND SWELLING IN PATIENTS UNDERGOING OPEN REDUCTION AND INTERNAL FIXATION FOR ZYGOMATICO-MAXILLARY COMPLEX FRACTURES

Abstract

Zygomatic bone fracture can cause significant disfigurement due to its prominence and complex anatomical location if proper surgical intervention is not provided. Surgical approaches in this region are associated with complications and morbidities ranging from mild swelling and pain to severe threat to vital function and esthetics. The purpose of this study was to compare the effect of post-operative administration of corticosteroids with non-steroidal anti-inflammatory agents in terms of pain and swelling in patients operated for Zygomatic complex fractures.

This randomized control trial was carried out in the department of Oral and Maxillofacial Surgery at Khyber College of Dentistry Peshawar. A total of 100 patients with Zygomatic complex fracture were recruited in this study. The patients were randomly allocated to two different groups by using prepared randomizations in sealed envelopes. In group 1, dexamethasone 8 mg was injected intraoperative and 4mg IV B.i.D for 48 hours postoperatively along with ibubrufen or diclofenac sodium while in group 2, only ibubrufen or diclofenac sodium alone were used. The degree of severity of pain was assessed by Visual Analog Scale ranging from no pain to severe pain categories on a 100 mm scale. The severity of the edema was estimated according to the criteria set by Torres. Analysis was done using SPSS version 20. Descriptive statistics were used to find out the frequencies and percentages for age, gender and type of fracture. Chi square and Fishers exact test were used for repeated measures for category rating scale, Pain and swelling. The level of significance was set at P < 0.05.

Out of 100 subjects, 71 were male while 29 were female with a male to female ratio of 2.44:1.The mean age of the participants was 31.73 12.7 years. Majority of the fractures were Type 4 (49%) followed by Type 3 fractures (33%). The pain and swelling intensity scores were significantly lower in Group 1 (Dexamethasone given) as compared to Group 2 (no Dexamethasone given) at 24 hours and 48 hours postoperatively ( p<0.5). No statistically significant difference was found between the study and control groups in terms of pain and swelling during the first 12 hours postoperatively.

Administration of dexamethasone in patient undergoing open reduction and internal fixation of zygomatic complex fractures have a profound effect on the reduction and prevention of pain and swelling as compared to those who received no dexamethasone after 12 hours.