Surgical versus non-surgical treatment of fractures of the articular process of the mandible

Hidding, J.; Wolf, R; Pingel, Dieter

doi:10.1016/s1010-5182(05)80363-4

Cited by 82 publications

(52 citation statements)

References 3 publications

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“…In spite of that, it seems that conservative methods may still provide acceptable results 17 (1983). There were 116 cases which were treated with Erich bars and intermaxillar fixation, combined with internal fixation with titanium miniplates and screws.…”

Section: Discussionmentioning

confidence: 99%

Facial fractures: a 1-year retrospective study in a hospital in Belo Horizonte

Chrcanovic¹,

Freire-Maia

Souza

et al. 2004

Braz. oral res.

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A retrospective study was performed to assess facial fractures in patients treated at a public hospital in Belo Horizonte, in 2000. The data collected included age, gender, etiology, distribution of maxillofacial trauma considering day of the week and month, anatomic site of the fracture, and treatment. The analyses involved descriptive statistics and chi-squared test, Bonferroni test and analysis of variance. A total of 1,326 facial fractures were found in 911 patients. Most fractures occurred in adults with age ranging from 21 to 30 years. Men were more affected than women, with a male-female ratio of 4.69:1. Accidents causing facial fractures occurred predominantly on weekends. Bicycle and motorcycle accidents were the major cause of trauma, followed by interpersonal violence, automobile accidents, and falls. When the relation between the gender and the etiology of facial fractures was analyzed, a significant relation was noted between these variables (p < 0.001). There was also a relation between the patients' age and the site of the fractures (p = 0.0014). The mandible was found to be the most commonly fractured bone in the facial skeleton, followed by the zygomatic complex and the nose. A non-surgical approach was chosen in most cases. There were significant differences between the kind of treatment applied and the site of the fracture (p < 0.001). DESCRIPTORS: Maxillary fractures; Mandibular fractures; Facial injuries; Epidemiologic studies. RESUMO:Um estudo retrospectivo foi realizado para avaliar fraturas faciais em pacientes atendidos no ano de 2000 em um hospital público de Belo Horizonte. As informações coletadas incluíam idade, sexo, etiologia, distribuição do trauma de acordo com o dia da semana e o mês, o local anatômico da fratura e o tratamento. As análises envolveram estatísticas descritivas, teste qui-quadrado, teste Bonferroni e análise de variância. Foram encontradas 1.326 fraturas de face em 911 pacientes. A maioria das fraturas ocorreu em adultos na faixa etária de 21 a 30 anos. Os homens foram mais acometidos do que as mulheres, numa proporção homem:mulher de 4,69:1. Os traumas causadores de fraturas faciais ocorreram predominantemente nos fins de semana. Os acidentes de moto e bicicleta foram a maior causa de trauma, seguidos por violência interpessoal, acidentes automobilísticos e quedas. Quando analisada a relação entre o gênero e a etiologia das fraturas de face, observou-se uma associação estatisticamente significativa entre essas variáveis (p < 0,001). Houve também uma associação entre a idade dos pacientes e a localização das fraturas (p = 0,0014). O osso facial mais fraturado foi a mandíbula, seguida por complexo zigomático e nariz. O tratamento conservador foi realizado na maioria dos casos. Houve diferenças estatisticamente significativas entre o tipo de tratamento instituído e a localização da fratura (p < 0,001).

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Section: Discussionmentioning

confidence: 99%

Facial fractures: a 1-year retrospective study in a hospital in Belo Horizonte

Chrcanovic¹,

Freire-Maia

Souza

et al. 2004

Braz. oral res.

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“…Although serious long-term complications of condylar fractures in growing children are rare, there is still a small, yet finite potential that condylar fractures may lead to untoward s e q~e l a e .~.~ case~.4.10.14.1 5,18,29,36 …”

Section: Discussionmentioning

confidence: 99%

“…Unlike older age groups, the short stocky nature of the condylar neck makes it relatively resistant to fracture. '^^ In the median age group (3-12 year olds) a more adult like configuration of the condylar process and glenoid fossa develops, although unlike adults, there still remains an enormous potential for regeneration and remodelling in this age g r o~p .~,~,~ For the older age group (13)(14)(15)(16)(17)(18) year olds) one finds that although the capacity for extensive new bone formation is equivalent to that of children, teenagers lack the corresponding capacity for condylar remodelling that is found in the younger age…”

Section: Pathophysiology Of Condylar Injuriesmentioning

confidence: 99%

Condylar injuries in growing patients

Dimitroulis

1997

Australian Dental Journal

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Although the mandibular condyle is one of the most common sites of injury of the facial skeleton, it is also the most overlooked and least diagnosed site of trauma in the head and neck region. The condyle forms the very cornerstone of mandibular form and function and therefore injuries to the mandibular condyle in growing children may adversely affect growth and development of the jaws and the occlusion. The aim of this article is to present an overview of condylar injuries in growing patients for the purpose of increasing the awareness of all dental practitioners involved in the treatment of children with acute oro-facial injuries.

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“…The relative indications given by Zide et al [4], for open treatment are bilateral subcondylar fractures in a patient without dentition splinting is impossible because of alveolar ridge atrophy, when splinting is not recommended for medical reasons and The success of the method of treatment adopted is greatly aided by the bone remodelling and functional adaptation that takes place. No substantial functional difference was found by Hidding et al [5], when they compared 34 surgically and non surgically treated patients. There was deviation in opening in 64% of patients treated conservatively as against 10% in surgically treated ones.…”

Section: Discussionmentioning

confidence: 80%

Management of Bilateral Condylar Fractures:Case Review

Chakraborty

2007

Medical Journal Armed Forces India

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bilaterally. There was no falling back of tongue. Reverse Towne's and postero anterior view of mandible revealed bilateral fracture at the neck of condyle with medial displacement of both the condylar heads and parasymphysis fracture with downward displacement of anterior fracture fragment. Arch bars and elastics were used to achieve occlusion and patient was taken up for open reduction and rigid internal fixation (RIF) under general anaesthesia (GA). An Alkayat and Bramley's modification of preauricular incision was used. The right TMJ was exposed and the condylar head was retrieved from its medially displaced position. After reduction, bone plating was done and hemostasis achieved. A corrugated rubber drain was inserted and the wound was sutured in layers. Intra orally a circum vestibular incision was given from left lower second premolar to right lower second premolar region. Mandibular degloving was done. A loose fragment of bone devoid of periosteal attachment was removed. The mandible had split sagitally resulting in the lingual cortex and labial cortex being pulled apart by muscular attachment. Bone plating was done from 45 to 33 region. Wound was sutured and TMJ movements were checked. Post operatively the patient had an uneventful recovery. Intermaxillary elastics were used to maintain occlusion for a period of three weeks, at the end of which his mouth opening was 38mm and occlusion was normal. Lateral movement of mandible was restricted. Jaw opening exercise was advised. Case Report -2A 13 year old patient fell from the roof of a school building, resulting in fracture of right sub condyle and neck of left condyle, exfoliation of 31, 32, 41, 42 and right parasymphysis fracture.There was overlapping of fracture fragments in right and undisplaced fracture condyle left. Open reduction and bone plating of right sub condylar fracture and right parasymphysis fracture was done under GA. The left condylar fracture was managed conservatively. Partial denture was provided for the missing teeth. Patient was reviewed after two months. Patient's occlusion was normal and his mouth opening was within normal limits.

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Surgical versus non-surgical treatment of fractures of the articular process of the mandible

Cited by 82 publications

References 3 publications

Facial fractures: a 1-year retrospective study in a hospital in Belo Horizonte

Facial fractures: a 1-year retrospective study in a hospital in Belo Horizonte

Condylar injuries in growing patients

Management of Bilateral Condylar Fractures:Case Review

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