Prognostic factors for long-term results after condylar head fractures: A comparative study of non-surgical treatment versus open reduction and osteosynthesis

Journal of Cranio-maxillo-facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery
Andreas KolkAndreas Neff

Abstract

This longitudinal study compared functional, anatomical, and quality of life (QoL) outcomes after closed reduction (CR) versus open reduction and internal fixation (ORIF) of condylar head fractures (CHFs). The aim was to determine predictability of results and to establish prognostic factors for poor outcomes, thus allowing therapeutic decision making between CR and ORIF. All fractures of the non-surgical group were treated by CR with maxillomandibular fixation (CR-MMF) according to an managed analogically. Morphological and functional results were acquired using axiography and clinical functional diagnostics, as well as MRI in problematic cases. Outcomes were compared with those of a collective of patients treated by ORIF with small fragment screws (SFS), according to a uniform standard. A total of 26 patients with 29 unilateral and bilateral CHFs of the non-surgical group were examined over a period of 28.5 months after completion of therapy and compared with a collective of 54 patients with 73 CHFs treated by ORIF. Statistically significant differences were found between both groups in protrusion and mediotrusion on the fracture side, in favour of ORIF. Significantly more patients in the ORIF group were symptom free in terms...Continue Reading

Citations

May 3, 2021·Journal of Cranio-maxillo-facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery·Karthik RamakrishnanChandran Saravanan

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