title: Prospective evaluation of a new classification system for the management of mandibular subcondylar fractures.
abstract: OBJECTIVE
  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.
  
  
  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.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Government Dental College, Pt. B.D. Sharma University of Health Sciences, Rohtak, Haryana, India. bhagol.amrish@gmail.com
authors.forename: Amrish
authors.initials: A
authors.lastname: Bhagol
authors.forename: Virendra
authors.initials: V
authors.lastname: Singh
authors.forename: Ish
authors.initials: I
authors.lastname: Kumar
authors.forename: Ajay
authors.initials: A
authors.lastname: Verma
mesh_terms: D000328:Adult; D003766:Dental Occlusion; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000379:methods; D006801:Humans; D019248:Jaw Fixation Techniques; D004204:Joint Dislocations / Q000145:classification / Q000628:therapy; D008297:Male; D008310:Malocclusion / Q000145:classification; D008335:Mandibular Condyle / Q000293:injuries*; D008337:Mandibular Fractures / Q000145:classification* / Q000601:surgery / Q000628:therapy; D016472:Motor Neuron Disease / Q000145:classification; D009046:Motor Neurons / Q000502:physiology; D010147:Pain Measurement; D010292:Paresthesia / Q000145:classification; D011446:Prospective Studies; D011862:Radiography, Panoramic; D016059:Range of Motion, Articular / Q000502:physiology; D012684:Sensory Thresholds / Q000502:physiology; D014110:Touch / Q000502:physiology; D016896:Treatment Outcome