[Evaluation of condylar fractures treatment].
BACKGROUND
We analysed 40 patients with mandibular condylar process fractures, treated through the closed (intermaxilary fixation or conservatively) or open methods (wire internal fixation,titanium miniplates, bone reduction or articular exploration), from January 1993 to January 1999.


METHODS
We evaluated these patients clinically with pre-determined criteria through the temporomandibular articulation touching (ATM), by observing the mandibular symmetry, dental oclusion, deviation to the mouth opening and maximum interincisal opening, besides the questionnaire about the complaints at ATM, disfunction of the mastication system and satisfaction of the treatment. We found an index of good clinical results of, at least, 70% (in the maximum interincisal opening) in the patients submitted to IMF. In the conservative method, we found an index of, at least, 42.9% and in the patients submitted to wire open reduction, at least, 28.6% (in the ATM touching exam) without significant difference in the clinical exams; the pain index at ATM in the closed method was 3.7% and in the open one was 15.4%; mastication disfunction was 22.2% in the closed method and 15.4% in the open one; we only found 7.1% dissatisfied patients in the closed method. There was no significant difference in the method results.


CONCLUSIONS
The closed method - with IMF and conservative - and the open reduction - with ORIF - brought good clinical results in an evaluation up to 6 months. We could also conclude that there is no difference in the complaint results after the open or closed treatment according to the patients' opinion.
Departamento de Cirurgia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil. eduandradefilho@zipmail.com.br
Eduardo Fausto de
EF
Andrade Filho
Dulce Maria Fonseca Soares
DM
Martins
Miguel
M
Sabino Neto
Carlos de Souza
Cde S
Toledo J nior Cd
Max Domingues
MD
Pereira
Lydia Massako
LM
Ferreira
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001864:Bone Wires; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000379:methods*; D005593:Fracture Fixation, Internal; D006801:Humans; D008297:Male; D008335:Mandibular Condyle / Q000293:injuries* / Q000601:surgery; D008337:Mandibular Fractures / Q000601:surgery*; D008875:Middle Aged; D011184:Postoperative Period; D012189:Retrospective Studies; D016896:Treatment Outcome