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Outcomes of open versus closed treatment in the management of mandibular subcondylar fractures.

Kim SY, Ryu JY, Cho JY, Kim HM - J Korean Assoc Oral Maxillofac Surg (2014)

Bottom Line: The average period of maxillomandibular fixation (MMF) was 5.47 days.The preoperative average tangential angulation of the fractured fragment was 3.67°, and loss of ramus height was 2.44 mm.The preoperative average tangential angulation of the subcondylar fragment was 8.66°, and loss of ramus height was 3.61 mm.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, Gachon University Gil Medical Center, Incheon, Korea.

ABSTRACT

Objectives: To compare the clinical and radiological outcomes after closed reduction (CR) and open reduction and internal fixation (ORIF) in the management of subcondylar fractures.

Materials and methods: Forty-eight patients presenting with subcondylar fracture between January 2010 and March 2013 were evaluated retrospectively. Fifteen patients were treated with CR and 33 patients with ORIF. The clinical and radiologic parameters were evaluated during follow-up (mean, 7.06 months; range, 3 to 36 months).

Results: In the CR group, no patients had any problems with regard to the clinical parameters. The average period of maxillomandibular fixation (MMF) was 5.47 days. The preoperative average tangential angulation of the fractured fragment was 3.67°, and loss of ramus height was 2.44 mm. In the ORIF group, no clinical problems were observed, and the average period of MMF was 6.33 days. The preoperative average tangential angulation of the subcondylar fragment was 8.66°, and loss of ramus height was 3.61 mm.

Conclusion: CR provided satisfactory clinical results, though ORIF provided more accurate reduction of the fractured fragment. So there is no distinct displacement of fractured fragment, CR should be selected than ORIF because of no need for surgery.

No MeSH data available.


Related in: MedlinePlus

Illustration showing the method by which tangential displacement was quantified on the panoramic view. A reference line was drawn through both gonial angles, and another line was drawn tangential to the posterior border of the condylar process on each side. The angle between the intersection of the tangent and the condylar process was calculated. The difference in this angle between the non-fractured and fractured sides was used as a measurement of tangential angulation.
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Figure 2: Illustration showing the method by which tangential displacement was quantified on the panoramic view. A reference line was drawn through both gonial angles, and another line was drawn tangential to the posterior border of the condylar process on each side. The angle between the intersection of the tangent and the condylar process was calculated. The difference in this angle between the non-fractured and fractured sides was used as a measurement of tangential angulation.

Mentions: Chart review was performed, and occlusion, maximal mouth opening, deviation on mouth opening, and nerve injury were evaluated. Radiologic assessment was also performed to evaluate the tangential angulation of the displaced fragment and loss of ramus height, as described in Palmieri et al.3. The amount of condyle fragment displacement (tangential angulation and loss of ramus height) was evaluated on panoramic radiographs at the first visit and three months later.(Figs. 1, 2)


Outcomes of open versus closed treatment in the management of mandibular subcondylar fractures.

Kim SY, Ryu JY, Cho JY, Kim HM - J Korean Assoc Oral Maxillofac Surg (2014)

Illustration showing the method by which tangential displacement was quantified on the panoramic view. A reference line was drawn through both gonial angles, and another line was drawn tangential to the posterior border of the condylar process on each side. The angle between the intersection of the tangent and the condylar process was calculated. The difference in this angle between the non-fractured and fractured sides was used as a measurement of tangential angulation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4279978&req=5

Figure 2: Illustration showing the method by which tangential displacement was quantified on the panoramic view. A reference line was drawn through both gonial angles, and another line was drawn tangential to the posterior border of the condylar process on each side. The angle between the intersection of the tangent and the condylar process was calculated. The difference in this angle between the non-fractured and fractured sides was used as a measurement of tangential angulation.
Mentions: Chart review was performed, and occlusion, maximal mouth opening, deviation on mouth opening, and nerve injury were evaluated. Radiologic assessment was also performed to evaluate the tangential angulation of the displaced fragment and loss of ramus height, as described in Palmieri et al.3. The amount of condyle fragment displacement (tangential angulation and loss of ramus height) was evaluated on panoramic radiographs at the first visit and three months later.(Figs. 1, 2)

Bottom Line: The average period of maxillomandibular fixation (MMF) was 5.47 days.The preoperative average tangential angulation of the fractured fragment was 3.67°, and loss of ramus height was 2.44 mm.The preoperative average tangential angulation of the subcondylar fragment was 8.66°, and loss of ramus height was 3.61 mm.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, Gachon University Gil Medical Center, Incheon, Korea.

ABSTRACT

Objectives: To compare the clinical and radiological outcomes after closed reduction (CR) and open reduction and internal fixation (ORIF) in the management of subcondylar fractures.

Materials and methods: Forty-eight patients presenting with subcondylar fracture between January 2010 and March 2013 were evaluated retrospectively. Fifteen patients were treated with CR and 33 patients with ORIF. The clinical and radiologic parameters were evaluated during follow-up (mean, 7.06 months; range, 3 to 36 months).

Results: In the CR group, no patients had any problems with regard to the clinical parameters. The average period of maxillomandibular fixation (MMF) was 5.47 days. The preoperative average tangential angulation of the fractured fragment was 3.67°, and loss of ramus height was 2.44 mm. In the ORIF group, no clinical problems were observed, and the average period of MMF was 6.33 days. The preoperative average tangential angulation of the subcondylar fragment was 8.66°, and loss of ramus height was 3.61 mm.

Conclusion: CR provided satisfactory clinical results, though ORIF provided more accurate reduction of the fractured fragment. So there is no distinct displacement of fractured fragment, CR should be selected than ORIF because of no need for surgery.

No MeSH data available.


Related in: MedlinePlus