title: A comparative clinical evaluation of the outcome of patients treated for bilateral fracture of the mandibular condyles.
abstract: OBJECTIVE
  To compare open reduction and internal fixation (ORIF) with closed treatment and maxillomandibular fixation (CRMMF) for management of bilateral subcondylar fractures of the mandible.
  
  
  METHODS
  This study involved a retrospective analysis of bilateral subcondylar fractures of the mandible treated at Government Dental College, Rohtak from 2007 to 2010. Data were collected by a review of pertinent inpatient and outpatient clinic records, and radiographic results. Patients were followed up weekly for 4 weeks and then at 2, 3 and 6 months after surgery. At these visits, careful attention was paid to clinical parameters included mouth opening, protrusion, laterotrusion, deviation on mouth opening and occlusion.
  
  
  RESULTS
  The patient sample ranged in age from 19 to 55 years, with an average age of 28.2 years. In total, 44 patients with 88 mandibular subcondylar fractures were included in the study. Out of these, 20 patients were managed by closed treatment and 24 by ORIF of the subcondylar fractures (19 unilateral and 5 bilateral). Regarding mouth opening/lateral excursion/protrusion, significant (p=0.00) differences were observed between both groups (open 37.6/11.5/5.9 mm versus closed 31.5/7.8/3.1mm). The visual analogue scoring revealed significant (p=0.00) difference with less pain in the operative treatment group (1.3 open versus 7.2 closed). Statistically significant difference was found between two groups for occlusion (p=0.00).
  
  
  CONCLUSIONS
  The current retrospective study shows that operative treatment was superior in all objective and subjective functional parameters. It is concluded that if either of the condyles is displaced ORIF is the most satisfactory method of treatment.
authors: Department of Oral and Maxillofacial Surgery, Government Dental College, Pt. B.D. Sharma University of Health Sciences, Rohtak 124001, Haryana, India. drvirendrasingh1@yahoo.co.in
authors: Virendra
authors: V
authors: Singh
authors: Amrish
authors: A
authors: Bhagol
authors: Rahul
authors: R
authors: Dhingra
mesh_terms: D000328:Adult; D001860:Bone Plates; D005081:Exercise Therapy; D005158:Facial Paralysis / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D018460:Fractures, Comminuted / Q000601:surgery / Q000628:therapy; D006801:Humans; D019248:Jaw Fixation Techniques; D008297:Male; D008310:Malocclusion / Q000209:etiology; D008335:Mandibular Condyle / Q000293:injuries*; D008337:Mandibular Fractures / Q000601:surgery* / Q000628:therapy; D008875:Middle Aged; D009068:Movement; D010147:Pain Measurement; D011183:Postoperative Complications; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult