Document Type : Original Article
Authors
1
Department of Plastic and Reconstructive Surgery, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt
2
Department of Plastic and Reconstructive Surgery, Al-Azhar University, Cairo, Egypt
Abstract
Background and aim: Management of sub-condylar fractures has been controversial for the last few years. Many surgeons think that closed treatment [CT] is better than reduction and internal fixation [ORIF] and say that there is no clinical significance between CT and ORIF. For this reason, many surgeons consider ORIF to be the best option for sub-condylar fractures.
Materials and Methods: Meta-analysis study to assess the potentiality of Open versus Closed techniques in management of unilateral subcondylar mandibular fractures which was performed In Adult, healthy Patients, and the outcome were investigated in our review which are the range of mandibular motion for a follow up period not less than 6 months.
Results: Studies included in meta-analysis were four papers , in relation to Maximal interincisal opening [MIO] , protrusive movement [PM] , and Lateral Excursion towards Non-Fracture Side [LENFS] , the mean difference were in favor of ORIF than closed treatment but the difference between the two groups was insignificant with MIO [MD = 2.80, 95% CI = [-0.70, 6.30], P value = 0.12 ] , PM [MD = 0.61, 95% CI = [-0.82, 2.04], P value = 0.40 ] , LENFS [MD = 1.66, 95% CI = [-0.48, 3.80], P value = 0.13], BUT in Lateral excursion towards fracture side [LEFS] , The mean difference of change was in the favor of ORIF and the difference between the two groups was significant [MD = 2.07, 95% CI = [1.56, 2.58], P value = 0.001].
Conclusion: Both treatment modalities provide acceptable outcomes with regards to mandibular motion. Our study favors open treatment for the management of displaced sub-condylar Mandibular fractures, and it is the favorable technique.
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