Page 118 - Open versus closed Mandibular condyle fractures

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Chapter 4.1 Open versus Closed
When the MFIQ for the patients with a unilateral fracture was correlated with gender, age, the presence of other fractures, cause of trauma, fracture type, use of MMF, presence of dentition, subjective occlusion, physiotherapy, education level, and length of follow-up, a significant effect was seen with subjective occlusion (P = 0.028), in which a better subjective occlusion resulted in a better result for the MFIQ, and also for the treatment received (P = 0.039), in which the outcome was in favor of the closed treatment methods.
DC/TMD
With regard to the Axis I assessment, myalgia was present in 5 (6.8%) patients: two had local myalgia, one had myofacial pain, and two had myofacial pain with referral. Of these five patients, two received open and three received closed treatment. Arthralgia was found in seven (9.5%) patients, of whom three were in the open group and four in the closed group; 67 (90.5%) patients were pain-free. No patient received a diagnosis of headache attributable to TMD. According to the DC/TMD, 66 (89.2%) patients did not receive a diagnosis of degenerative joint disorder. Eight (10.8%) patients did have a form of degenerative joint disorder, with most cases involving the contralateral side to the condyle fracture (62.5%). Two of these patients received open treatment and six closed treatment. No intra-articular joint disorders were seen in 56 (75.7%) patients. The other 18 (24.3%) patients had disc displacement with reduction, which showed no correlation with the fracture site.
When corrected for overbite, the mean MMO for unilateral fractures was 53.9 mm (standard deviation (SD) 5.0 mm) after open treatment and 53.3 mm (SD 7.4 mm) after closed treatment (P = 0.799). The mean protrusion was 7.7 mm (SD 1.8 mm) after open treatment and 8.8 mm (SD 2.7 mm) after closed treatment (P = 0.214).
The mean maximum laterotrusion movements were as follows: left 9.3 mm (SD 3.1 mm), right 10.5 mm (SD 2.7 mm) after open treatment, and left 10.6 mm (SD 3.3 mm), right 10.7 mm (SD 3.2 mm) after closed treatment (P = 0.265 and P = 0.864, respectively). There were no cases of ankylosis.
With regard to the Axis II assessment, the results from the questionnaires are given in Table 2. No significant difference between the open and the closed treatment groups was found for any of the questionnaire scores.