Evaluating the efficacy of disc repositioning in the management of high condylar fracture — A prospective clinical trial

Abstract

AimThe aim of the study was to assess the role of disc repositioning in treating high condylar fractures. Materials and methodsPatients who reported to the Department of Oral and Maxillofacial surgery with high condylar fractures were recruited for this study, and randomized into two groups. The study group underwent ‘disc repositioning during ORIF’, while ‘ORIF without disc repositioning’ was performed for the control group.Patients were assessed for pain, mouth opening, clicking, and mandibular deviation (Helkimo clinical dysfunction Index), preoperatively and postoperatively (immediate and at 3 months). The position of the disc was assessed by MRI preoperatively and at 3 months postoperatively. Results24 patients were included in the study, and divided equally into test (N = 12) and control (N = 12) groups. Descriptive statistics were used to find the means and standard deviations of the parameters, and inferential statistics to assess p-values, using an independent-sample t-test. At 3 months after surgery, 10 patients in the test group demonstrated absence of pain (mean 0.1 ± 0.3), while only one patient was pain free in the control group (mean 5.2 ± 2.3). There was a significant improvement in mouth opening in the study group (mean 37.4 ± 3.4) in comparison with the control group (mean 22.5 ± 9.5). The study group demonstrated favourable surgical outcomes for all parameters (p < 0.0001), aside from clicking. ConclusionWithin the limitations of the study, disc repositioning in high condylar fractures appeared to demonstrate a positive effect on TMJ function, and hence should be considered in appropriate indications.