Outcomes Of Open Versus Closed Treatment Of Unilateral Mandibular Subcondylar Fractures

Purpose: The aim of this retrospective study was to compare operative and conservative treatment of the unilateral subcondylar fractures of the mandible.Objective to provide an objective basis for choosing the treatment for subcondylar fractures.Methods: A total of 42 adult patients with unilateral mandibular subcondylar fractures were treated in the Department of oral and maxillofacial surgery,General Hospital of Ningxia Medical University from October 2014 to December 2016.The medical records of the patients were complete,the examination and diagnosis were perfect,and the imaging examination was complete(CT reconstruction of the mandible,the surface of the body,CBCT).After 6 months of follow-up,the patients were followed up for the clinical information and imaging examination,and the results were evaluated.Subjective description included pain and pain in the joint area,and the objective measurement indexes included the degree of mouth opening,the angle of mandibular condyle displacement and the height of mandibular ramus.The measurement data to mean + standard deviation(??+ s),using t test.Count data to rate(%),with ?2 test.P<0.05 had statistical significance.Results: 42 cases of mandibular subcondylar fracture patients,the ratio of male to female was 4.25:1,including conservative treatment in 15 cases,surgical treatment in 26 cases,the use of submandibular incision in 5 case,the posterior incision in 18 cases,the original incision in 3 cases.1 cases were lost to follow-up in the last 6 months.Follow up after June,surgical treatment group and conservative treatment group,treatment group to obtain the correct anatomical reduction of fracture,the degree of mouth opening,condylardisplacement angle and ramus height change in the two groups were significantly different(P<0.05).Among them,the surgical treatment group of two kinds of surgical approach postoperative curative effect comparison showed no difference,There were no infection,occlusal disorder,permanent facial paralysis and salivary fistula.Conclusion: 1.Traffic accident is the main cause of mandibular subcondylar fracture.2.Most of the mandibular condylar fractures were male,and the most common one in the combined injury was the mandibular fracture,accounting for about 53%.3.In this study,when the condylar displacement angle between 10 °-30 °,mandibular ramus vertical height reduction ? 3 mm,the surgical treatment group after the efficacy of the indicators were better than the conservative treatment group.4.There were no significant differences in the surgical treatment of mandibular subcondylar fractures after the operation of the posterior maxillary approach and the submandibular approach.