Complications in the Treatment of Mandibular Condylar Fracture, Surgical Versus Non-Surgical Treatment

Tehreem A. Khan, M. Shabbir
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Abstract

Background: The facial fractures include Condylar fractures are most common in mandibular fractures, which have the highest fracture incidence after nasal bone fractures. Three different traumatic forces can result in condylar injury: the first is energy imparted to a static person by a moving object, such as a blow to the face from a cricket bat; the second is a moving person striking a static object, such as a child falling and striking the ground; and the third is a combination of the first two forces, such as when a person is moving and an automobile is moving and is hit by an automobile. This kind of force typically has the biggest impact and causes the most severe injury patterns. Objective: To compare frequency of Complications of two procedures for the treatment of mandibular condylar fracture surgical versus conservative treatment. Methodology: This Randomized control trial was held in the Tertiary Care Hospital Karachi for 6 months from 12 Jul, 2019 to 12 Jan, 2020. ERC were taken before data collection. Patients suffering from mandibular condylar fracture and fulfilling exclusion and inclusion criteria and who were ready to give informed consent after explaining study protocol, risk benefit ratio and data usage for research were included in our study. The first group labelled as "A" was treated by closed reduction and immobilization and second group labelled as group "B" was undergone internal fixation and open reduction. Results: The mean age and standard deviation of the 72 patients was determined to be 40.85 ± 12.93 years, respectively, with the 18 years was the minimum age and the 65 years being maximum. Frequency of gender was shown in Graph 1.The minimum duration of fracture was 1 day, and maximum were 7 days. The minimum mouth opening was 15mm and maximum was 35mm (Table 1). Trismus was present in 5/72 (6.9%) patients while it was absent in 67/72 (93.1%) patients (Table 2). Malocclusion was present in 20/72 (27.8%) patients while it was absent in 52/72 (72.2%) patients. Unilateral Side of fracture was present in 40/72 (55.6%) patients while Bilateral was present in 32/72 (44.4%) patients (Table 3) Conclusions: In conclusion, closed reduction had clinically satisfactory results, although open reduction and internal fixation produced more accurate to reduce the complications. Keywords: Closed reduction, Internal fixation, Open reduction,complications
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下颌骨髁突骨折的并发症,手术治疗与非手术治疗
背景:下颌骨折中以髁突骨折最为常见,其骨折发生率仅次于鼻骨骨折。三种不同的创伤力可导致髁突损伤:第一种是运动物体传递给静态人的能量,例如板球拍对面部的击打;第二种是移动的人撞击静止的物体,比如小孩摔倒撞击地面;第三种力是前两种力的结合,比如当一个人在运动,一辆车在运动,然后被车撞了。这种力量通常具有最大的影响,并导致最严重的伤害模式。目的:比较两种方法治疗下颌髁突骨折手术与保守治疗的并发症发生率。方法:该随机对照试验于2019年7月12日至2020年1月12日在卡拉奇三级保健医院进行,为期6个月。数据采集前进行ERC检查。符合排除和纳入标准,并在解释研究方案、风险收益比和研究数据使用后准备给予知情同意的下颌髁骨折患者纳入我们的研究。第一组标记为“A”,进行闭合复位固定,第二组标记为“B”,进行内固定和开放复位。结果:72例患者的平均年龄为40.85±12.93岁,最小年龄为18岁,最大年龄为65岁。性别频率见图1。骨折时间最短1天,最长7天。最小开口15mm,最大开口35mm(表1)。5/72(6.9%)患者出现牙关紧闭,67/72(93.1%)患者无牙关紧闭(表2)。20/72(27.8%)患者出现牙合错,52/72(72.2%)患者无牙合错。单侧骨折占40/72(55.6%),双侧骨折占32/72(44.4%)(表3)结论:闭合复位临床效果令人满意,尽管切开复位和内固定产生更准确,减少并发症。关键词:闭合复位,内固定,切开复位,并发症
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