Prospective evaluation of a new classification system for the management of mandibular subcondylar fractures.

Purpose: We propose a new classification of subcondylar fractures of the mandible based on ramal height shortening and degree of fracture angulation and present our treatment experience using this classification system. Patients and Methods: Eighty patients with subcondylar fractures of the mandible...

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Published in:Journal of Oral & Maxillofacial Surgery (02782391) Vol. 69; no. 4; pp. 1159 - 1166
Main Authors: Bhagol A, Singh V, Kumar I, Verma A, Bhagol, Amrish, Singh, Virendra, Kumar, Ish, Verma, Ajay
Format: research randomized controlled trial Journal Article
Published: W B Saunders Apr2011
Online Access:View this record in EBSCOhost
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      dt: Apr2011
      vid: 69
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      pub: W B Saunders
      place: Philadelphia, Pennsylvania
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        10.1016/j.joms.2010.05.050
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        atl: Prospective evaluation of a new classification system for the management of mandibular subcondylar fractures.
      aug:
        au:
          Bhagol A
          Singh V
          Kumar I
          Verma A
          Bhagol, Amrish
          Singh, Virendra
          Kumar, Ish
          Verma, Ajay
        affil: Department of Oral and Maxillofacial Surgery, Government Dental College, Pt. B.D. Sharma University of Health Sciences, Rohtak, Haryana, India
      sug:
        subj:
          Mandibular Condyle Injuries
          Mandibular Fractures Classification
          Adult
          Dental Occlusion
          Dislocations Classification
          Dislocations Therapy
          Female
          Fracture Fixation Methods
          Human
          Male
          Malocclusion Classification
          Mandibular Fractures Surgery
          Mandibular Fractures Therapy
          Motor Neuron Diseases Classification
          Motor Neurons Physiology
          Pain Measurement
          Paresthesia Classification
          Perception
          Prospective Studies
          Radiography, Panoramic
          Randomized Controlled Trials
          Range of Motion Physiology
          Surgery, Oral
          Touch Physiology
          Treatment Outcomes
          Adult: 19-44 years
          Female
          Male
      ab: Purpose: We propose a new classification of subcondylar fractures of the mandible based on ramal height shortening and degree of fracture angulation and present our treatment experience using this classification system. Patients and Methods: Eighty patients with subcondylar fractures of the mandible were evaluated. We categorized the fractures into 3 classes: Class 1 (minimally displaced), fracture with ramal height shortening: <2 mm and/or degree of fracture displacement: <10°; Class 2 (moderately displaced), fracture with ramal height shortening: 2 to 15 mm and/or degree of fracture displacement: 10 to 35°; Class 3 (severely displaced), fracture with ramal height shortening: >15 mm and/or degree of fracture displacement: >35°. Our treatment protocol is closed treatment for Class 1 fractures; either closed or open treatment for Class 2 fractures; and open treatment for Class 3 fractures. Results: Among 80 patients, 20 had Class 1 fractures (25%), 40 had Class 2 fractures (50%), and 20 had Class 3 fractures (25%). In Class 2 fractures, 22 patients were managed by closed treatment (Class 2a) and 18 by open treatment (Class 2b). No statistically significant differences were found between the 3 classes in terms of functional outcome, while, within Class 2 patients, significantly (P = .00) better functional results were observed in open (Class 2b) group compared with closed group (Class 2a). Conclusions: Our new classification based on ramal height shortening and degree of fracture displacement can better guide clinical treatment. Class 1 fractures are treated by closed method, while open reduction is recommended in Class 2 and Class 3 cases.
      pubtype: Academic Journal
      doctype:
        research
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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