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Fractures of the mandibular condyle--Open versus closed--A treatment dilemma
Muhammed Shiju1, Sanjay Rastogi2, Prashant Gupta3
1Oral and Maxillofacial Surgery, Jaipur Dental College, Jaipur, Rajasthan, India.
Purpose:
The aim of this prospective randomized controlled study was to evaluate the superiority of open method of treatment of mandibular condylar fracture over closed method of treatment by comparing them.
Methods And Patients:
Out of a total of 50 randomized patients fractures of the mandibular condylar process completed the study and were evaluated. All fractures were displaced, being either angulated between 10° and 45°. The follow-up examinations 1st day, 2nd day, 1st week, 2nd week, 6th week, and 6 months following treatment included clinical evaluation of functional and subjective parameters including visual analogue scale for pain and the interincisal mouth opening, malocclusion, deviation of mouth, range of motion, radiographic measurements were done.
Results:
No significant difference was found between the two groups in the maximal interincisal opening, range of movements and TMJ pain. However statistically significant difference was seen in the anatomic reduction of condyle, shortening of ascending ramus, occlusal status and deviation on mouth opening on immediate postoperative phase.
Conclusion:
Both treatment options for condylar fractures of the mandible yielded acceptable results. However, a statistically significant difference was seen in the anatomic reduction of the condyle and there was no deviation on maximum mouth opening in patients treated with open reduction and internal fixation which suggests its superiority over closed method.
