Comparison of functional outcome after open and closed reduction of mandibular subcondylar fracture.

Samira Shabbir Balouch Samira Shabbir Balouch,Riaz Ahmad Warraich Riaz Ahmad Warraich,Sadia Awais Sadia Awais,Rana Sohail Rana Sohail,Mir Ibrahim Sajid Mir Ibrahim Sajid

doi:10.47391/jpma.1263

Samira Shabbir Balouch Samira Shabbir Balouch, Riaz Ahmad Warraich Riaz Ahmad Warraich + Show 3 more

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https://doi.org/10.47391/jpma.1263

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Abstract

To compare open reduction with internal fixation of mandibular subcondylar fracture with closed reduction in terms of adequate mouth opening. The randomised clinical trial was conducted from March 2014 to February 2015 at the Oral and Maxillofacial Surgery Department, King Edward Medical University and Allied Hospitals, Lahore, Pakistan, and comprised patients who presented with unilateral subcondylar fractures. The patients were randomly divided into 2 groups. Group-A patients were treated with closed reduction and immobilisation and were discharged the same day, while Group-B patients were treated by open reduction with internal fixation and retained in ward for 1 day. Both were recalled for periodic follow-ups, and were compared in terms of achieving adequate mouth opening. Data was analysed using SPSS 20. Of the 70 patients, 35(50%) were in each of the two groups. The mean age in Group-A was 28.88±11.86 years compared to 28.22±10.80 years in Group-B (p>0.05). Mean mouth opening in the two groups were consistently positive, and significant at the last two follow ups(p<0.001). The difference in results of both treatment modalities was significant, indicating that open reduction and internal fixation should be the preferred treatment.

Highlights

Mandibular fractures are frequently seen in road traffic accidents (RTAs), sports injuries and interpersonal violence, with the most common sites of fracture being parasymphysis and mandibular subcondyle
Treatment needs to be methodised for effective management of Mandibular subcondylar fractures (MCFs) in terms of adequate mouth opening and patient satisfaction
The mean age in group A was 28.88±11.86 years compared to 28.22±10.80 years in group B

Summary

Introduction

Mandibular fractures are frequently seen in road traffic accidents (RTAs), sports injuries and interpersonal violence, with the most common sites of fracture being parasymphysis and mandibular subcondyle. Mandibular subcondylar fractures (MCFs) account for 25-35% of the total mandibular fractures.[1] The mode, vector and site of impact influence the fracture diversity. MCF hinders various joint movements and hampers optimal mouth opening.[2] These fractures need to be treated to avoid severe functional disabilities, including restricted mouth opening, malocclusion, compromised lateral excursion of the condyle and deviation on ov is io na lly. Treatment needs to be methodised for effective management of MCFs in terms of adequate mouth opening and patient satisfaction

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