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Unilateral Subcondylar and Condylar Neck Fractures: Randomized Clinical Study
Tajamul Ahmad Hakim1, Ajaz Ahmed Shah1, Shahid Farooq1
1Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Srinagar, Jammu and Kashmir, India.
Annals of Maxillofacial Surgery
|July 3, 2018
Summary
Open reduction internal fixation (ORIF) offers superior functional outcomes for condylar neck fractures compared to closed treatment, with less pain and better mouth opening. Both methods provide acceptable results, but ORIF excels in objective and subjective parameters.
Area of Science:
- Oral and Maxillofacial Surgery
- Orthopedic Surgery
- Trauma Surgery
Background:
- Condylar neck fractures are common facial trauma injuries.
- Treatment options include closed reduction and open reduction internal fixation (ORIF).
- Optimal management strategies require comparative analysis.
Purpose of the Study:
- To compare the efficacy of closed treatment versus ORIF for subcondylar and condylar neck fractures.
- To evaluate functional outcomes and patient-reported pain.
- To assess anatomical reduction and occlusion.
Main Methods:
- A randomized prospective study of 30 patients with displaced condylar fractures.
- Group I: Closed treatment with maxillomandibular fixation (4 weeks).
- Group II: ORIF using miniplates; followed for 6 months, assessing key functional parameters.
Main Results:
- ORIF achieved significantly more accurate anatomical reduction compared to closed treatment.
- Operative treatment showed significant improvements in maximal interincisal opening, protrusion, and lateral excursion.
- Patients undergoing ORIF reported significantly less pain postoperatively.
Conclusions:
- Both closed treatment and ORIF yield acceptable results for condylar fractures.
- ORIF demonstrates superiority in objective and subjective functional outcomes, excluding occlusion.
- Operative intervention is recommended for enhanced functional recovery.
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