Open Versus Closed Treatment of Unilateral Subcondylar and Condylar Neck Fractures: A Prospective, Randomized Clinical Study
Open Versus Closed Treatment of Unilateral Subcondylar and Condylar Neck Fractures: A Prospective, Randomized Clinical Study
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DOI：
10.1016/j.joms.2009.09.042
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发表时间：
2010-06-01
影响因子：
1.9
通讯作者：
Siddareddi, Avinash
中科院分区：
文献类型：
--
作者：
Danda, Anil Kumar;Muthusekhar, Mr.;Siddareddi, Avinash
目的：本研究的目的是比较开放复位内固定与闭合治疗移位的单侧髁下和髁颈骨折。材料和方法：共32例移位的单侧髁状突骨折患者纳入本研究。32例患者中，27例为男性，5例为女性。将患者分为2组。I组采用闭合治疗和坚强内固定; II组采用切开复位内固定。评估患者的最大切间开口、屈曲运动、骨折侧和非骨折侧的侧向偏移运动、影像学上髁状突的解剖复位、颞下颌关节疼痛和咬合不正。使用独立t检验对两组之间骨折侧和非骨折侧的最大切缘间开口、屈曲运动和侧向偏移运动等参数进行统计学比较。结果：两组患者的髁突解剖复位、颞下颌关节疼痛、错牙合畸形、前伸、侧移、最大开口、颞下颌关节疼痛等指标差异无统计学意义;然而，在髁状突的解剖复位方面观察到统计学显著差异。本研究的结果表明，闭合治疗与严格的上下颌固定或开放复位的患者之间不存在显著的临床差异和内固定。然而，切开复位内固定治疗的患者在影像学上观察到髁突更好的解剖复位。(C)2010年美国口腔颌面外科医师协会J Oral Maxillofac Surg 68：1238-1241，2010
Purpose: The purpose of the present study was to compare closed treatment with open reduction and internal fixation for displaced unilateral subcondylar and condylar neck fractures.Materials and Methods: A total of 32 patients with displaced unilateral condylar fractures were included in the present study. Of the 32 patients, 27 were men and 5 were women. The patients were divided into 2 groups. The group I patients were treated with closed treatment and rigid maxillomandibular fixation, and group II patients were treated with open reduction and internal fixation. The patients were assessed for maximal interincisal opening, protrusive movements, lateral excursion movements on the fractured and nonfractured sides, anatomic reduction of the condyle on radiography, pain in the temporomandibular joint, and malocclusion. Parameters such as the maximal interincisal opening, protrusive movements, and lateral excursion movements on the fractured and nonfractured sides between the 2 groups were compared statistically using an independent t test. Parameters such as anatomic reduction of the condyle, pain in the temporomandibular joint, and malocclusion between the 2 groups were compared statistically using the chi(2) test.Results: No significant difference was found between the 2 groups in the maximal interincisal opening, protrusion, lateral excursion movement,, malocclusion, and temporomandibular joint pain; however, a statistically significant difference was seen in the anatomic reduction of the condyle.Conclusions: The results of the present study have shown that no significant clinical difference exists between patients undergoing closed treatment and rigid maxillomandibular fixation or open reduction and internal fixation. However, a radiographically better anatomic reduction of the condylar process was seen in the patients treated with open reduction and internal fixation. (C) 2010 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 68:1238-1241, 2010