Open versus closed treatment for extracapsular fracture of the mandibular condyle
이준영, 정희영, 류재영, 정승곤, 국민석, 박홍주, 오희균,
소속 상세정보
이준영 ( Lee Jun-Yeong ) - Chonnam National University School of Dentistry Department of Oral and Maxillofacial Surgery
정희영 ( Jung Hee-Yeoung ) - Chonnam National University School of Dentistry Department of Oral and Maxillofacial Surgery
류재영 ( Ryu Jae-Young ) - Chonnam National University School of Dentistry Department of Oral and Maxillofacial Surgery
정승곤 ( Jung Seung-Gon ) - Chonnam National University School of Dentistry Department of Oral and Maxillofacial Surgery
국민석 ( Kook Min-Suk ) - Chonnam National University School of Dentistry Department of Oral and Maxillofacial Surgery
박홍주 ( Park Hong-Ju ) - Chonnam National University School of Dentistry Department of Oral and Maxillofacial Surgery
오희균 ( Oh Hee-Kyun ) - Chonnam National University School of Dentistry Department of Oral and Maxillofacial Surgery
Abstract
Objectives: Selection of treatment methods for mandibular condylar fractures remains controversial. In this study, we investigated treatment methods for condylar fractures to determine the indications for open or closed reduction.
Patients and Methods: Patients >12 years of age treated for mandibular condylar fractures with a follow-up period of ≥3 months were included in this study. The medical records of enrolled patients were reviewed for sex, age, fracture site, treatment method (open or closed reconstruction), postoperative intermaxillary fixation period, operation time, and complications. Radiological analysis of fracture fragment displacement and changes in ramal height difference was performed using computed tomography and panoramic radiography.
Results: A total of 198 patients was investigated, 48.0% (n=95) of whom underwent closed reduction and 52.0% (n=103) underwent open reduction. There was no significant correlation between reduction method and patient sex, age, or follow-up period. No statistically significant difference between the incidence of complications and treatment method was observed. None of the patients underwent open reduction of condylar head fracture. Binary logistic regression analysis showed that open reduction was significantly more frequent in patients with subcondylar fracture compared to in those with a fracture in the condylar head area. There was no statistically significant correlation between the groups and fracture fragment displacement. However, there was a significant difference between the treatment groups in amount of change in ramal height difference between the fractured and the nonfractured sides during treatment.
Conclusion: No significant clinical differences were found between the open and closed reduction methods in patients with mandibular condylar fractures. According to fracture site, closed reduction was preferred for condyle head fractures. There was no significant relationship between fracture fragment displacement and treatment method.
키워드
Mandibular fracture; Open fracture reduction; Closed fracture reduction
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