26 IBM, Armonk, NY, USA), and P-values less than 0.05 were considered statistically significant.
#A patient underwent closed reduction of a closed fracture software#
2) Statistical analysis was performed using IBM SPSS Statistics software (ver. This was measured on both the fractured and non-fractured sides 9.( Fig.
Ramal height on panoramic image was defined as the distance from the highest point of the mandibular condyle to the intersection of the tangent to the mandibular inferior border and the posterior edge of the ramus. This difference was investigated between the CR and OR groups. In addition, among patients treated for unilateral condylar fractures with displacement, the difference in ramal height of the fractured and the non-fractured sides before treatment and ≥3 months after treatment was measured using panoramic radiography. 1) Among patients treated for unilateral condylar fractures, we investigated the relationships between fracture characteristics and treatment method using binary logistic regression analysis. Displacement of the fracture fragment was defined as abnormal position of the fractured condylar fragment in relation to the distal segment bone in the CT images.( Fig. Radiological analysis of fracture fragment displacement was performed using computed tomography (CT) and panoramic radiography. To compare the complications, amount of mouth opening, temporomandibular disorder (TMD), malocclusion, and facial nerve weakness were evaluated through a review of the medical records. Medical records of the patients were reviewed for sex, age, fracture site, treatment method (OR or CR), and postoperative intermaxillary fixation (IMF). Mandibular condylar fractures were classified as condylar head, condylar neck, or subcondylar fractures. CNUH-2022-164), and the informed consent was waived by the IRB. This study was approved by the Institutional Review Board (IRB) of Chonnam National University Hospital (IRB No. This study followed the medical protocols and ethics guidelines outlined in the Declaration of Helsinki (2013). Analysis was performed on patients >12 years of age, who were expected to have permanent dentition. Patients who were treated for mandibular condylar fractures at the Department of Oral and Maxillofacial Surgery, Chonnam National University Hospital, from 2011 to 2020 with a follow-up period ≥3 months were included in this study. In this study, the treatment method for condylar fractures was investigated to determine the indications for OR or CR. Depending on the presence of malocclusion, displacement of the fracture fragment, dislocation of the condyle, and unilateral or bilateral fracture, treatment for condylar fractures can vary.Īlthough there are reports that OR is preferred when the fracture fragment is displaced and CR otherwise, there is significant controversy about which of the two methods is more effective 7, 8. Conversely, CR carries the advantages of being non-invasive and less likely to damage anatomical structures but has its own disadvantages, such as malocclusion, MOL, facial asymmetry, chronic pain, ankylosis, and a prolonged treatment period 3 - 6. During OR, three-dimensional stability of the mandible can be obtained through proper reduction of the fracture fragment, action of the lateral pterygoid muscle, a relatively fast recovery for a normal diet, and a short treatment period however, there is the potential for damage to the facial nerve, blood vessels, and joint capsules or infection with this approach. Mandibular condylar fractures can be treated using open reduction (OR) or closed reduction (CR).
Clinically, complications such as malocclusion, anterior open bite, residual pain, mouth opening limitation (MOL), pathological changes in the temporomandibular joint (TMJ), osteonecrosis, facial asymmetry, and ankylosis may occur due to condylar fractures, and appropriate treatment is required to avoid these complications 1, 2. Mandibular condylar fractures are accompanied by dental trauma or concomitant fractures on the contralateral side. Mandibular condylar fractures are common, and their most frequent causes are traffic accidents, violence, slip-down, fall-down, and sports.
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