MANAGEMENT OF MANDIBULAR CONDYLAR FRACTURES; A RANDOMIZED CONTROLLED TRIAL

Abstract

Objective: To evaluate the treatment outcome and post operative complications of different treatment modalities for condylar fractures.
Meterial and Methods:Total 70 patients of both genders and all ages were enrolled in the current study. Different treatment modalities were employed to treat condylar fractures. These include conservative therapy by putting patient on soft diet and active physiotherapy, closed reduction using arch bar with inter arch elastics, closed reduction using eyelet wiring and maxillomandibular fixation and open reduction and internal rigid fixation using titanium mini plates. All patients were reviewed after one week, two weeks, one month, two months and six months of initial treatment for evaluation of treatment effects and complications.
Results:Total 70 patients were included in this study aged 5 to 47 years. Most of the patients were males (80%), with females constituting only 20 % of the cases. Majority of patients were in age group 21-30 years (40%) followed by 11-20 years (25.7%). Regarding the etiological factors of injuries, fall (45.7%) was found to be more prevalent followed by RTA (40%). Various treatment modalities were used to treat fractures; majority was treated by closed reduction with arch bar (37.1 %) followed by closed reduction with eyelet wiring (25.8%). The most common complication was malocclusion (30.77%) followed by jaw deviation (23.07%).
Conclusion:Mandibular condylar fractures should be treated conservatively in children and in those cases where fractures are unilateral and minimally displaced as there is no difference in the outcome of results whether these fractures are treated conservatively or with open reduction and fixation. Open reduction and fixation should be preferred in absolute indications for open treatment.