하악골 과두 골절의 관혈적 정복술과 비관혈적 정복술의 예후에 관한 후향적 연구 = RETROSPECTIVE STUDY FOR PROGNOSIS AFTER OPEN AND CLOSED REDUCTION OF THE MANDIBULAR CONDYLE FRACTURES

다국어 초록 (Multilingual Abstract)

Condylar process of mandible, has the specialized anatomic structure compared with any other body structure, acts directly in connection with mastication and speech and so on. In general, mandibular condyle fractures have been managed by two methods as open and closed reduction. But, there are no reasonable consensus about the proper management of this injury. This study was designed for analysis of the prognosis of two methods of treatment, open and closed reduction, with positional change of fractured condyle and complications within 6 months post-intermaxillary fixation period. We conducted a retrospective analysis of 154 patients whose unilateral mandibular condyle fractures were treated by open or closed reduction in our department. The horizontal, sagittal, and coronal change of the condyle was examined using modified Towne's and panoramic radiographs before intermaxillary fixation(IMF), immediately after IMF, and at 6 months after IMF. Patients, whose mandibular condyle fractures were treated by closed reduction, had significantly shorter ramus height on the side of injury(P<0.05). But, fractured condylar fragments were displaced insignificantly with aspect to sagittal and coronal plane(P>0.05). The level of the fracture influenced the ramus length and the degree of coronal change in the closed reduction group(P<0.05). There was no significant correlation among the level of the fracture, treatment methods and complications(P>0.05). From the results obtained in this study, fractured mandibular condyles, were treated by closed reduction, had a tendency that continuous condylar displacement was occurred with aspect to horozontal and coronal plane in treatment period including intermaxillary fixation. And then there was a correlation between the level of the fracture and the position change in close reduction group statistically. These result suggested that care must be taken in basing treatment decisions on the degree of displacement of the condyle and in treating the mandibular condyle fractures for a long time.

참고문헌 (Reference)

1 "Therapy of condylar neck fractures" 247-254, 1998

2 "Surgical versus nonsurgical treatment of unilateral dislocated low subcondylar fractures a clinical study of 52 cases" 353-359, 1994

3 "Severe bone resorption and osteoarthrosis after miniplate fixation of high condylar fractures A clinical and radiologic study of thirteen patients" 400-407, 1991

4 "Remodeling of the TM joint after conservative treatment of condylar fractures" 91-98, 1987

5 "Principles of oral and maxillofacial surgery" Lippincott Co -640 586, 1992

6 "Outcomes of open versus closed treatment of mandibular subcondylar fractures" 370-375, 2001

7 "Outcomes of open versus closed treatment of mandibular subcondylar fractures" 370-375, 2001

8 "Osteotomy-osteo synthesis in displaced condylar fractures" 267-70, 1989

9 "Open treatment of condylar process fractures Assessment of adequacy of repositioning and maintanence of stability" 27-34, 2000

10 "Open reduction without fixation of dislocated condylar process fractures" 553-561, 1998

11 "Open reduction of subcondylar fratures A study of functional rehabilitation" 107-111, 1996

12 "Open reduction and rigid fixation of subcondylar fractures Rigid fixation of the craniomaxillofacial skeleton" Butterworth-Heinemann -216, 1992

13 "Non-surgical treatment of condylar fractures in adults" 162-167, 2003

14 "Mandibular motion after closed and open treatment of unilateral mandibular condylar process fractures" 764-775, 1999

15 "Management of injuries to the temporomandibular joint region" -434, 1991

16 "Injuries of the condylar and coronoid process" Churchill Livingstone -362 417, 1985

17 "Indications for open reduction of mandibular condyle fractures" 89-98, 1983

18 "Further displacement of condylar process fractures after closed treatment" 1307-1316, 1999

19 "Fractures of the condylar process" 392-397, 1999

20 "Facial asymmetry after closed and open treatment of fractures of the mandibular condylar process" 719-728, 2000

21 "Determinants of treatment and outcome" 155-163, 2004

22 "Condylar fractures of the mandible II A radiographic study of remodeling process of temporomandibular joint" 153-165, 1977

23 "Condylar fractures of the mandible Classification and relation to age and concomitant injuries of teeth and teeth-supporting structures and fractures of the mandibular body" 12-21, 1977a

24 "Condylar displacement after sagittal splitting of the mandibular rami" 278-287, 1980

25 "Computed tomographic findings of the fractured mandibular condyle after open reduction" 469-473, 2003

26 "Comparison of panoramic and standard radiographs for the diagnosis of mandibular fractures" 677-679, 1986

27 "Comparison of functional recovery after nonsurgical and surgical treatment of condylar fractures" take (take): 1191-1195, 1990

28 "Clinico-stastical analysis of possible factors leading to problems in the surgical treatment of unilateral mandibular condyle fractures" 31-39, 2001

29 "Axial 'anchor' screw or 'slanted-screw' plate for osteosynthesis of fractures of the mandibular condyloid process" 348-353, 1993

30 "Analysis od possible factors leading problems after nonsurgical treatment of condylar fractures" 793-799, 1994

31 "A study of condylar fractures in Sri Lankan patients with special reference to the recent views on treatment" 391-397, 1987

32 "A method to rigidly fix high condylar fractures" 369-374, 1989

33 "15 years follow-up on condylar fractures" 1989