CLINICAL OUTCOMES FOLLOWING OPEN VERSUS CLOSED TREATMENT OF MANDIBULAR CONDYLE FRACTURE: OUR EXPERIENCE IN MANITOBA

Reda Elgazzar* and Saba Naghipur

ABSTRACT

Objectives: Mandibular condylar fracture is an extremely common injury in facial trauma but treatment remains controversial. The objective of this study was to provide a better understanding of clinical outcomes following different treatment modalities of condylar fracture of the mandible. Materials and Methods: We conducted a retrospective analysis using charts from patients who presented with condylar fracture to Health Sciences Center in Winnipeg, MB from 2007-2011. Ninety-seven patients were divided into three treatment groups based on management of condylar fracture: closed reduction, open reduction and internal fixation (ORIF), and conservative treatment. A data collection sheet was created for each patient to record pre-intra- postoperative patient information. Complications were recorded immediately post-operatively and at the end of follow-up period. Results: A total of 65 patients underwent closed reduction, 29 patients with displaced condylar fractures underwent ORIF, and 3 were treated conservatively. The most common complication in all treatment groups was limited inter-incisal mouth opening (<40 mm), followed by malocclusion. A small number of patients experienced temporomandibular joint (TMJ) dysfunction and mandibular deviation. No statistical difference was found in complications between open and closed treatment (P>0.05). The most common surgical complication in ORIF patients was post-operative infection occurring in 5 patients (17.2%), followed by transient facial nerve weakness occurring in 4 (13.8%) patients. Wound dehiscence, sialocele, fistula formation, scarring, and screw loosening were also observed. Conclusion: Both open and closed treatment modalities showed comparable clinical outcomes, and both presented minor-moderate post-operative complications, which were managed successfully.

Keywords: Mandibular Condylar fracture; ORIF, Closed Reduction, Conservative treatment; Complication.