Iatrogenic Delay in Diagnosis of Temporo-Mandibular Joint Ankylosis: A Cross Sectional Analysis of Thirty Four Trauma Patients from Central India

Background : Temporo-mandibular joint Ankylosis is a significant problem in central India, aggravated by the delay of diagnosis due to various factors. The iatrogenic delay is a main reason why patients suffer in pain and ultimately get jaw lock due to ankylosis. Material and Methods : A total of 34 patients exhibited temporo-mandibular joint Trauma. They were distributed in three groups, first had (11) patients, who showed no evidence of any ankylosis, second ten (10) who showed fibrous ankylosis and the third, (13) patients who exhibited bony ankylosis .The analysis was further done that they belonged to (rural) group and the (urban) group .The former had 16 patients and latter18 patients. Statistical comparison of the iatrogenic delay in rural and urban group was made using the Decision Analyst Stat TM 2.0. Results : The iatrogenic delay per doctor was 3.67 months for rural and 2.94 months in urban areas. The patients who had no ankylosis had mean iatrogenic delay of 1.85 months, Fibrous ankylosis group had mean iatrogenic delay of 2.94 months and those suffering (bony ankylosis) had mean delay of about 19.6 months. Conclusion : The iatrogenic delay was a key factor in neglect of the trauma patients who resulted in the fibrous and bony ankylosis. We found that (rural) patients had statistically significant delay in diagnosis as compared with the urban.