ORIGINAL ARTICLE   

European Journal of Oral and Maxillofacial Surgery 2021 August;5(2):51-7

DOI: 10.23736/S2532-3466.20.00233-7

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Comparison of clinical efficacy of open reduction and internal fixation versus closed reduction and mandibulo-maxillary fixation in the management of low-level subcondylar fractures

Abdul M. SHAHID ¹, Muhammad JAMAL ² ✉, Muhammad U. FAROOQ ³, Muhammad M. SALEEM ⁴

¹ Department of Oral Medicine, Islamabad Medical and Dental College, Islamabad, Pakistan; ² Department of Oral and Maxillofacial Surgery, Islamabad Medical and Dental College, Islamabad, Pakistan; ³ Department of Oral and Maxillofacial Surgery, Pakistan Institute of Medical Sciences, Islamabad, Pakistan; ⁴ Department of Oral and Maxillofacial Surgery, Hitec Dental College, Taxila, Pakistan

BACKGROUND: The aim of the preset study was to measure and compare the clinical efficacy of open reduction and internal fixation versus closed reduction and mandibulomaxillary fixation in low-level subcondylar fractures.
METHODS: This Interventional comparative study was carried out for two years in the Department of Oral and Maxillofacial Surgery, Pakistan Institute of Medical Sciences, Islamabad on 90 patients with low level subcondylar fracture. The patients were divided into two equal groups. Forty-five patients, belonging to Group A, were treated under general anesthesia by rigid fixation with mini titanium plates, while 45 patients of Group B were treated under local anesthesia by closed reduction and mandibulo-maxillary fixation. Occlusion was checked subjectively and objectively between the two groups during the postoperative period after 1 week, 6 weeks, 3 months, 6 months and 1 year.
RESULTS: After the first week of follow-up 8% patients treated with ORIF reported with poor occlusion and 13% patients treated with CRMMF reported with poor occlusion (P value = 0.370) whereas after the 6^th week of follow-up 6% patients reported with poor occlusion treated with ORIF and 8% reported with poor occlusion treated with CRMMF (P value = 0.50). There were 4% patients who reported with poor occlusion when treated with ORIF and similarly 4% patients reported poor occlusion who were treated with CRMMF at 3^rd month follow-up post operatively (P value = 0.692). At 6-month follow-up, 2% of patients reported with poor occlusion from each group respectively and the post op occlusion improved of the period of 1 year and there were no reported poor occlusions either with ORIF or CRMMF. The results were statistically not significant which showed that on 6^th month (P value = 0.753) and 1-year follow-up (P value = NS).
CONCLUSIONS: The study concludes that there is no significant difference in the treatment of subcondylar fracture either by closed reduction or open reduction.

KEY WORDS: Open fracture reduction; Fracture fixation, internal; Fracture fixation; Fractures, bone