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  • Evaluation of surgical treatment in mandibular condyle fractures
    Vesnaver, Aleš ; Ahčan, Uroš ; Rozman, Janez, 1956-
    In the past, fractures of the mandibular condylar process were, as a rule, treated conservatively. At the Department of Maxillofacial and Oral Surgery ofthe University Medical Centre Ljubljana, ... Slovenia, our doctrine was changed in 2002 on the basis of preliminary results and reports in the literature, andthese fractures were started to be treated surgically by open reduction andinternal fixation with miniplates and screws, which led to good results anda shorter rehabilitation period. The goal of this study was to determine the safety and efficiency of surgical treatment, as well as to compare long-term results of surgical and conservative treatment, as objectively as possible. PATIENTS AND METHODS: Two groups of patients, which had all sustained a unilateral, extra-articular mandibular condyle fracture, were compared. In the test group, there were 42 surgically treated patients, and inthe control group, 20 conservatively treated patients. Clinical parameters and X-ray images were assessed in both groups and compared by the two tailed Student t test, and in case of attributive variables by the Ž(2) test. Within the surgically treated group, postoperative and intraoperative complications were noted: temporary facial nerve palsy, development of a parotid salivary fistula, disturbance of auricle sensibility due to injury of the greater auricular nerve, miniplate fracture, as well as intraoperative bleeding, postoperative haematoma formation, infection, reoperation due to fragment malposition and other complications. Postoperative scars were also assessed. RESULTS: Statistically significant differences between the surgically and conservatively treated patients were found when comparing clinical parameters as well as X-ray images, the results being better in the surgically treated group. Complications of surgical treatment were also noted, the most importantamong them temporary paresis of facial nerve branches, which occurredin 10 patients (24%). Plate fractures occurred in five patients (12%),in four of them miniplates of sizes less than 2.0mm were used. There were no cases of significant intraoperative bleeding, two cases (5%) required drainage of postoperative haematomas, and one patient (2%) experienced a mild postoperative infection, which was easily controlled with amoxicillin with clavulanic acid. The scar was hidden best if a facelift incision was used, anda hypertrophic scar developed in only one patient (2%). CONCLUSION: Results of surgical treatment of condylar process fractures are superior to the results of conservative treatment, and the procedure is safe with the transparotid surgical approach and adequate surgical technique.
    Vir: Journal of cranio-maxillo-facial surgery. - ISSN 1010-5182 (Vol. 40, no. 8, Dec. 2012, str. 647-653)
    Vrsta gradiva - članek, sestavni del
    Leto - 2012
    Jezik - angleški
    COBISS.SI-ID - 415660
    DOI

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