Management of Condylar Fractures; Comparative Outcomes of Conservative Closed Versus Open Reduction

Abstract

Objective: To compare the frequency of complications after closed and open reduction management
of condylar fractures.
Methods: This is a casual-comparative study conducted in the Out-patient & ward, Department of Oral & Maxillofacial Surgery, Nishter Institute of Dentistry, Multan, over a period of six months. Through nonprobability consecutive sampling, 178 patients were recruited and randomly allotted to two groups,
Group 1 for closed reduction and Group 2 for open reduction. A non-rigid mandibular splint was applied
for one month in Group 1 whereas, a pre-auricular incision was given and the fracture was reduced and fixed by mini-plates in Group 2. Patients of both groups were given antibiotics intravenously and were followed up clinically for complications such as pain and mandibular deviation after one month by employing “The Visual Analog Scale”. Data were analyzed using SPSS version (21) employing descriptive statistics and Chi-square test.
Results: Mean age was found to be 26.48 ± 4.62 years in Group 1 and 24.85 ± 6.05 years in Group 2. Male to-female ratio, mean weight, height and BMI were almost similar in both groups. The mean duration of fracture was 7.101 ± 2.24 days in Group 1 and 6.898 ± 2.21 days in Group 2. The mandibular deviation was seen in 33.7% and 16.9% of patients (p=0.009) respectively in Groups 1 & 2. The pain was seen in 41.6% of patients in Group 1 and 24.7% in Group 2 (p=0.016).
Conclusion: Considering the complications encountered, patients treated by open reduction gave better
clinical results in comparison to close reduction management of condylar fractures.