Yıl: 2023 Cilt: 30 Sayı: 3 Sayfa Aralığı: 544 - 550 Metin Dili: İngilizce DOI: 10.17343/sdutfd.1349794 İndeks Tarihi: 02-10-2023

THE RELATIONSHIP BETWEEN THE TREATMENT APPROACHES AND COMPLICATIONS IN MANDIBULAR SUBCONDYLAR FRACTURES

Öz:
Objective Although mandibular condylar fractures represent one of the most frequent types of fractures in the mandible, their treatment remains controversial. This study aimed to determine the safety of treatment method, reduce postoperative complications, and describe our clinical experience. Material and Method Fifty-three patients with subcondylar mandibular fractures were included. The patients were treated with closed reduction (CR) or open reduction and internal fixation (ORIF). Arch bar or intermaxillary screws, and rubber were used for intermaxillary fixation (IMF) in all patients. Statistical analysis was subsequently performed. Results A total of 37 male patients and 16 female patients were included in this study. Falls were the most common cause of mandibular fractures in the study (n=23; 43.3%). Postoperative complications included malocclusion, temporomandibular dysfunction (mouth opening less than 30 mm), facial nerve neuropathy, and infection. There was no statistically significant difference between the CR and ORIF groups in the postoperative complication of malocclusion.All patients with malocclusion (n=8) had concomitant fractures (n=23). There was a statistically significant difference between the subgroups (group with concomitant fracture and group without concomitant fracture) in terms of postoperative malocclusion complications. A mean duration of 21 days was also always associated with temporomandibular dysfunction. Conclusion This study demonstrated the need for balancing the pros and cons in determining the proper treatment choice. ORIF has several advantages; however, it can be accompanied by postoperative complications. The duration of IMF can lead to functional disorders, and patients should cooperate with consultants in the treatment decision.
Anahtar Kelime: closed reduction intermaxillary fixation mandibular subcondyl fracture malocclusion

MANDİBULAR SUBKONDİLER KIRIKLARDA TEDAVİ YAKLAŞIMLARI İLE KOMPLİKASYONLAR ARASINDAKİ İLİŞKİ

Öz:
Amaç Mandibula kondil kırıkları, mandibulada en sık görülen kırık türlerinden biri olmasına rağmen tedavisi tartışmalıdır. Bu çalışmanın amacı tedavi yönteminin güvenliğini belirlemek, postoperatif komplikasyonları azaltmak ve klinik deneyimimizi anlatmaktır. Gereç ve Yöntem Subkondiler mandibular kırığı olan 53 hasta dahil edildi. Hastalar kapalı redüksiyon (KR) veya açık redüksiyon ve internal fiksasyon (ARIF) ile tedavi edildi. Tüm hastalarda intermaksiller fiksasyon (IMF) için arch bar veya intermaksiller vidalar ve lastik kullanıldı. Ardından istatistiksel analiz yapıldı. Bulgular Çalışmaya toplam 37 erkek hasta ve 16 kadın hasta dahil edildi. Çalışmada mandibula kırıklarının en sık nedeni düşmelerdi (n=23; %43,3). Ameliyat sonrası komplikasyonlar arasında maloklüzyon, temporomandibular disfonksiyon (ağız açıklığının 30 mm'den az olması), fasiyal sinir nöropraksisi ve enfeksiyon yer alıyordu. Ameliyat sonrası maloklüzyon komplikasyonu açısından KR ve ARIF grupları arasında istatistiksel olarak anlamlı bir fark yoktu.Maloklüzyona sahip hastaların tamamında (n=8) eşlik eden kırıklar (n=23) mevcuttu. Ameliyat sonrası maloklüzyon komplikasyonu açısından alt gruplar (eşlik eden kırığı olan grup ve eşlik eden kırığı olmayan grup) arasında istatistiksel olarak anlamlı fark vardı. Ortalama 21 günlük bir süre de her zaman temporomandibular disfonksiyon ile ilişkilendirilmiştir Sonuç Bu çalışma, uygun tedavi seçiminin belirlenmesinde avantaj ve dezavantajları dengelemenin gerekliliğini ortaya koymuştur. ARIF'in birçok avantajı vardır; ancak ameliyat sonrası komplikasyonlar da eşlik edebilir. IMF'nin kullanım süresi fonksiyonel bozukluklara yol açabileceğinden hastaların tedavi kararında hekimlerle iş birliği yapması gerekmektedir.
Anahtar Kelime: kapalı redüksiyon intermaksiller fiksasyon mandibular subkondil kırığı maloklüzyon

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Ellis E III, Dean J. Rigid fixation of mandibular condyle fractures. Oral Surg Oral Med Oral Pathol 1993;76:6–15
  • 2. Lindahl L. Condylar fractures of the mandible. I. Classification and relation to age, occlusion, and concomitant injuries of teeth and teeth-supporting structures, and fractures of the mandibular body. Int J Oral Surg 1977;6:12-21
  • 3. Lee HC, Kang DH, Koo SH, et al. The outcome of open reduction via retromandibular approach for mandibular subcondyle fracture. J Korean Soc Plast Reconstr Surg 2005;32:739- 743
  • 4. Kim SY, Ryu JY, Cho JY, et al. Outcomes of open versus closed treatment in the management of mandibular subcondylar fractures, J Korean Assoc Oral Maxillofac Surg 2014; 40(6):297-300
  • 5. Zide MF, Kent JN. Indications for open reduction of mandibular condyle fractures. J Oral Maxillofac Surg 1983;41:89-98
  • 6. Lee W, Kang DH. Study of the plating methods in the experimental model of mandibular subcondyle fracture. J Korean Cleft Palate-Craniofac Assoc 2011;12:12-16
  • 7. Zide MF, Kent JN. Indications for open reduction of mandibular condyle fractures. J Oral Maxillofac Surg 1983;41:89–98
  • 8. Sugamata A, Yoshizawa N, Jimbo Y. Open Reduction of Subcondylar Fractures Using a New Retractor, Plast Surg Int 2011;2011:421245
  • 9. Rutges JP, Kruizinga EH, Rosenberg A, et al. Functional results after conservative treatment of fractures of the mandibular condyle. Br J Oral Maxillofac Surg 2007;45:30–34
  • 10. Hlawitschka M, Loukota R, Eckelt U. Functional and radiological results of open and closed treatment of intracapsular (diacapitular) condylar fractures of the mandible. Int J Oral Maxillofac Surg 2005;34:597–604
  • 11. Landes CA, Day K, Lipphardt R, et al. Prospective closed treatment of nondisplaced and nondislocated condylar neck and head fractures versus open reposition internal fixation of displaced and dislocated fractures. Oral Maxillofac Surg 2008;12:79–88
  • 12. Ellis III E, McFadden D, Simon P, et al. Surgical complications with open treatment of mandibular condylar process fractures. J Oral Maxillofac Surg 2000;58:950–958
  • 13. Manisali M, Amin M, Aghabeigi B, et al. Retromandibular approach to the mandibular condyle: a clinical and cadaveric study. Int J Oral Maxillofac Surg 2003;32:253–256
  • 14. Narayanan V, Kannan R, Sreekumar K. Retromandibular approach for reduction and fixation of mandibular condylar fractures:a clinical experience. Int J Oral Maxillofac Surg 2009;38:835–839
  • 15. Biglioli F, Colletti G. Transmasseter approach to condylar fractures by mini- retromandibular access. J Oral Maxillofac Surg 2009;67:2418–2424
  • 16. Romagnoli R, Bernardi M, Tagliente F, et al. Effect of immobilization after treatment of mandibular fractures, Minerva Stomatol 1999;48:203-208
  • 17. Larry H. Soft tissue and Skeletal Injuries of the Face. In:Harry Hollier JR, Kelley Patrick. Grabb, Smith Plastic Surgery (6th Ed.) Philadelphia, Lippincott Williams and Wilkins, 2007; 315- 332.
  • 18. Theologie-Lygidakis N, Chatzidimitriou K, Tzerbos F, et al. Nonsurgical management of condylar fractures in children: A 15-year clinical retrospective study. J Craniomaxillofac Surg 2016;44:85-93
  • 19. Kempers K.G, Quinn PD, Silverstein K. Surgical approaches to mandibular condylar fractures: a review. J Craniomaxillofac Trauma 1999; 5:25–30
  • 20. Nam SN, Lee JH, Kim JH. The application of the Risdon approach for mandibular condyle fractures. BMC Surg. 2013;13:25
  • 21. Jose A, Yadav P, Roychoudhury A, et al. Study of Topographic Anatomy of Temporal and Marginal Mandibular Branches of the Facial Nerve in Relation to Temporomandibular Joint Surgery. J Oral Maxillofac Surg 2021; 79:343.e1-343.e11
APA Tapan M, Ergani H (2023). THE RELATIONSHIP BETWEEN THE TREATMENT APPROACHES AND COMPLICATIONS IN MANDIBULAR SUBCONDYLAR FRACTURES. , 544 - 550. 10.17343/sdutfd.1349794
Chicago Tapan Mehmet,Ergani Hasan Murat THE RELATIONSHIP BETWEEN THE TREATMENT APPROACHES AND COMPLICATIONS IN MANDIBULAR SUBCONDYLAR FRACTURES. (2023): 544 - 550. 10.17343/sdutfd.1349794
MLA Tapan Mehmet,Ergani Hasan Murat THE RELATIONSHIP BETWEEN THE TREATMENT APPROACHES AND COMPLICATIONS IN MANDIBULAR SUBCONDYLAR FRACTURES. , 2023, ss.544 - 550. 10.17343/sdutfd.1349794
AMA Tapan M,Ergani H THE RELATIONSHIP BETWEEN THE TREATMENT APPROACHES AND COMPLICATIONS IN MANDIBULAR SUBCONDYLAR FRACTURES. . 2023; 544 - 550. 10.17343/sdutfd.1349794
Vancouver Tapan M,Ergani H THE RELATIONSHIP BETWEEN THE TREATMENT APPROACHES AND COMPLICATIONS IN MANDIBULAR SUBCONDYLAR FRACTURES. . 2023; 544 - 550. 10.17343/sdutfd.1349794
IEEE Tapan M,Ergani H "THE RELATIONSHIP BETWEEN THE TREATMENT APPROACHES AND COMPLICATIONS IN MANDIBULAR SUBCONDYLAR FRACTURES." , ss.544 - 550, 2023. 10.17343/sdutfd.1349794
ISNAD Tapan, Mehmet - Ergani, Hasan Murat. "THE RELATIONSHIP BETWEEN THE TREATMENT APPROACHES AND COMPLICATIONS IN MANDIBULAR SUBCONDYLAR FRACTURES". (2023), 544-550. https://doi.org/10.17343/sdutfd.1349794
APA Tapan M, Ergani H (2023). THE RELATIONSHIP BETWEEN THE TREATMENT APPROACHES AND COMPLICATIONS IN MANDIBULAR SUBCONDYLAR FRACTURES. Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi, 30(3), 544 - 550. 10.17343/sdutfd.1349794
Chicago Tapan Mehmet,Ergani Hasan Murat THE RELATIONSHIP BETWEEN THE TREATMENT APPROACHES AND COMPLICATIONS IN MANDIBULAR SUBCONDYLAR FRACTURES. Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi 30, no.3 (2023): 544 - 550. 10.17343/sdutfd.1349794
MLA Tapan Mehmet,Ergani Hasan Murat THE RELATIONSHIP BETWEEN THE TREATMENT APPROACHES AND COMPLICATIONS IN MANDIBULAR SUBCONDYLAR FRACTURES. Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi, vol.30, no.3, 2023, ss.544 - 550. 10.17343/sdutfd.1349794
AMA Tapan M,Ergani H THE RELATIONSHIP BETWEEN THE TREATMENT APPROACHES AND COMPLICATIONS IN MANDIBULAR SUBCONDYLAR FRACTURES. Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi. 2023; 30(3): 544 - 550. 10.17343/sdutfd.1349794
Vancouver Tapan M,Ergani H THE RELATIONSHIP BETWEEN THE TREATMENT APPROACHES AND COMPLICATIONS IN MANDIBULAR SUBCONDYLAR FRACTURES. Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi. 2023; 30(3): 544 - 550. 10.17343/sdutfd.1349794
IEEE Tapan M,Ergani H "THE RELATIONSHIP BETWEEN THE TREATMENT APPROACHES AND COMPLICATIONS IN MANDIBULAR SUBCONDYLAR FRACTURES." Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi, 30, ss.544 - 550, 2023. 10.17343/sdutfd.1349794
ISNAD Tapan, Mehmet - Ergani, Hasan Murat. "THE RELATIONSHIP BETWEEN THE TREATMENT APPROACHES AND COMPLICATIONS IN MANDIBULAR SUBCONDYLAR FRACTURES". Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi 30/3 (2023), 544-550. https://doi.org/10.17343/sdutfd.1349794