Open Reduction and Internal Fixation Versus Closed Reduction and Maxillomandibular Fixation of Condylar Fractures of the Mandible: A Prospective Study.

Rathod Prakash,Ramesh K,Aditya M Alwala,Manjusha ,Rachana Porika,Saideep Katkuri

doi:10.7759/cureus.21186

Abstract

BackgroundThe choice of surgical versus nonsurgical treatment for fractures of the condylar process has its own limitations and remains a controversial issue. Improved knowledge of anatomy, technique, and technology combined with adequate experience with careful planning of surgical technique can avoid all the possible complications.AimTo compare open reduction and internal fixation with closed reduction and maxillomandibular fixation in the management of condylar fractures.Materials and methodA prospective study was carried out among 22 patients who had minimally displaced or displaced condylar fractures. The patients were divided into two groups of 11 each: group A patients treated with open reduction and rigid internal fixation and group B patients treated with closed reduction and maxillomandibular fixation. Follow-up examinations were performed at one week, one month, three months, and six months postoperatively.ResultsPreauricular pain was significantly decreased (p < 0.001) in both groups postoperatively but more significantly decreased in the open reduction group. There was a significant improvement in the mouth opening at every follow-up to a maximum mean of 37.36 mm in group A and a mean of 33.64 mm in group B. Significantly more improvement in protrusive and lateral movements and reduced deviation on mouth opening at every follow up was observed in the open reduction group.ConclusionBoth the treatment options for condylar fractures of the mandible yielded acceptable results with significant clinical differences in terms of occlusion, mouth opening, functional movements, and pain among patients with open reduction.

Highlights

The face contains many structures that are a predominant cause of morbidity during facial injuries
The patients were divided into two groups of 11 each: group A patients treated with open reduction and rigid internal fixation and group B patients treated with closed reduction and maxillomandibular fixation
The present study aims to compare the outcome of open reduction and internal fixation versus closed reduction and maxillomandibular fixation of condylar fracture of the mandible

Summary

Introduction

The face contains many structures that are a predominant cause of morbidity during facial injuries. Maxillofacial (MF) injuries are one of the foremost health problems that remain a serious clinical problem [1]. There can be a few aspects of maxillofacial trauma management that generate more controversy than the fracture involving the condylar process of the mandible [4]. The treatment goal of condylar fracture should be pain-free mandibular motion, good occlusion, and symmetry [5]. The choice of treatment method, i.e., conservative or surgical management in adults, is a controversial issue among oral and maxillofacial surgeons around the world. The choice of surgical versus nonsurgical treatment for fractures of the condylar process has its own limitations and remains a controversial issue. Technique, and technology combined with adequate experience with careful planning of surgical technique can avoid all the possible complications

Methods

Discussion

Conclusion