title: Which Factors Are Associated with Open Reduction of Adult Mandibular Condylar Injuries?
abstract: BACKGROUND
  The purpose of this study was to identify factors associated with the decision to perform open reduction and internal fixation of mandibular condylar fractures.
  
  
  METHODS
  This was a retrospective cohort study of patients with mandibular condylar fractures managed by the plastic and reconstructive surgery, oral and maxillofacial surgery, and otorhinolaryngology services over a 15-year period. Bivariate associations and a multiple logistic regression model were computed for injury characteristics that were associated with open reduction and internal fixation. For all analyses, a value of p ≤ 0.05 was considered significant.
  
  
  RESULTS
  Six hundred fifty-four condylar injuries were identified in 547 patients. The sample's mean age was 36.0 ± 16.5 years, 20.5 percent were women, and 63 percent were Caucasian. The most common mechanisms of injury were motor vehicle collisions (49 percent), 53.4 percent involved the subcondylar region and 20 percent were bilateral injuries. Associated noncondylar mandibular fractures were present in 60 percent of cases; 20.7 percent were managed with open reduction and internal fixation. The overall complication rate was 21.6 percent. In a multiple logistic regression model, factors associated with an increased likelihood of open reduction and internal fixation were the presence of extracondylar mandibular injuries, condylar neck or subcondylar region injuries, increasing dislocation, and treatment by plastic and reconstructive surgery/oral and maxillofacial surgery (p ≤ 0.04).
  
  
  CONCLUSIONS
  Increasing severity of mandibular injury, lower level of fracture, joint dislocation, and treatment by plastic and reconstructive surgery/oral and maxillofacial surgery are associated with open reduction and internal fixation of mandibular condylar injuries.
  
  
  METHODS
  Risk, III.
authors.affiliation: Baltimore, Md.; and New York, N.Y.|From the Division of Plastic, Maxillofacial, and Reconstructive Surgery and the Department of Oral and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine; the Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital; and the Department of Plastic Surgery, New York University Langone Medical Center.
authors.forename: Howard D
authors.initials: HD
authors.lastname: Wang
authors.affiliation: Baltimore, Md.; and New York, N.Y.|From the Division of Plastic, Maxillofacial, and Reconstructive Surgery and the Department of Oral and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine; the Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital; and the Department of Plastic Surgery, New York University Langone Medical Center.
authors.forename: Srinivas M
authors.initials: SM
authors.lastname: Susarla
authors.affiliation: Baltimore, Md.; and New York, N.Y.|From the Division of Plastic, Maxillofacial, and Reconstructive Surgery and the Department of Oral and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine; the Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital; and the Department of Plastic Surgery, New York University Langone Medical Center.
authors.forename: Gerhard S
authors.initials: GS
authors.lastname: Mundinger
authors.affiliation: Baltimore, Md.; and New York, N.Y.|From the Division of Plastic, Maxillofacial, and Reconstructive Surgery and the Department of Oral and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine; the Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital; and the Department of Plastic Surgery, New York University Langone Medical Center.
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Schultz
authors.affiliation: Baltimore, Md.; and New York, N.Y.|From the Division of Plastic, Maxillofacial, and Reconstructive Surgery and the Department of Oral and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine; the Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital; and the Department of Plastic Surgery, New York University Langone Medical Center.
authors.forename: Robin
authors.initials: R
authors.lastname: Yang
authors.affiliation: Baltimore, Md.; and New York, N.Y.|From the Division of Plastic, Maxillofacial, and Reconstructive Surgery and the Department of Oral and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine; the Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital; and the Department of Plastic Surgery, New York University Langone Medical Center.
authors.forename: Branko
authors.initials: B
authors.lastname: Bojovic
authors.affiliation: Baltimore, Md.; and New York, N.Y.|From the Division of Plastic, Maxillofacial, and Reconstructive Surgery and the Department of Oral and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine; the Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital; and the Department of Plastic Surgery, New York University Langone Medical Center.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Christy
authors.affiliation: Baltimore, Md.; and New York, N.Y.|From the Division of Plastic, Maxillofacial, and Reconstructive Surgery and the Department of Oral and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine; the Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital; and the Department of Plastic Surgery, New York University Langone Medical Center.
authors.forename: Paul N
authors.initials: PN
authors.lastname: Manson
authors.affiliation: Baltimore, Md.; and New York, N.Y.|From the Division of Plastic, Maxillofacial, and Reconstructive Surgery and the Department of Oral and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine; the Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital; and the Department of Plastic Surgery, New York University Langone Medical Center.
authors.forename: Eduardo D
authors.initials: ED
authors.lastname: Rodriguez
authors.affiliation: Baltimore, Md.; and New York, N.Y.|From the Division of Plastic, Maxillofacial, and Reconstructive Surgery and the Department of Oral and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine; the Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital; and the Department of Plastic Surgery, New York University Langone Medical Center.
authors.forename: Amir H
authors.initials: AH
authors.lastname: Dorafshar
mesh_terms: D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008297:Male; D008335:Mandibular Condyle / Q000000981:diagnostic imaging / Q000293:injuries*; D008337:Mandibular Fractures / Q000175:diagnosis / Q000601:surgery*; D008338:Mandibular Injuries / Q000175:diagnosis / Q000601:surgery*; D008875:Middle Aged; D000070799:Open Fracture Reduction / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult