Evaluation of open and closed treatments of displaced sub condylar fractures

الملخص

Background:The treatment of condylar process fractures has generated a great deal of discussion and controversy in oral and maxillofacial trauma and there are many different methods to treat this injury.
Aim of study:To evaluate the methods of treatment of displaced condylar fractures, open or closed and pointing out their indications and contraindication. Materials and methodes:Forty patients (20-50 years old) were selected with displaced sub condylar fractures unilateral or bilateral from January 2009 to September 2009. All patients were treated in maxillofacial unit,  hospital of specialized surgery, in Medical City, Bagdad. This study protocol involves all the types of displacement of sub condylar region
which can be diagnosed clinically and plain x-ray.By using all of above whether can evaluate the patients if need surgical or functional treatment (only mandibulo maxillary fixation).
Results:In our study we classified the displaced sub condylar fracture according to Row 1982 classification and we found the high percentage was medially displaced. We treated 12 patients from 40 patients surgically and 28 patients functionally and we found some of complications with the patients who were treated surgically as infection and visible scar, while the complications of displaced subcondylar fractures which are treated functionally are deviation during mouth opening, temporo mandibular joint pain, asymmetry of face and malocclusion.
Conclusion:With difficulties of follow up, for those patients with displaced sub condylar fractures which cannot be treated functionally (MMF) or still malocclusion evenly after using elastic band in MMF we preferred the open reduction with internal rigid fixation by extra oral approach.