Does Fracture Pattern Influence Functional Outcomes in the Management of Bilateral Mandibular Condylar Injuries?. Issue 3 (September 2019)

• Record Type: Journal Article
• Authors: Wang, Howard D.; Susarla, Srinivas M.; Yang, Robin; Mundinger, Gerhard S.; Schultz, Benjamin D.; Banda, Abhishake; MacMillan, Alexandra; Manson, Paul N.; Nam, Arthur J.; Dorafshar, Amir H.
• Is Part Of: Craniomaxillofacial trauma & reconstruction. Volume 12:Issue 3(2019)
• Page Start: 211
• Page End: 220
• Publication Date: 2019-09
• Subjects: mandibular condyles -- condylar fractures -- mandible fractures -- bilateral condylar fractures; Face -- Wounds and injuries -- Periodicals; Face -- Surgery -- Periodicals; Maxilla -- Wounds and injuries -- Periodicals; Maxilla -- Surgery -- Periodicals; Face -- Surgery; Face -- Wounds and injuries; Maxilla -- Surgery; Maxilla -- Wounds and injuries; Maxillofacial Injuries -- Periodicals; Craniocerebral Trauma -- Periodicals; Reconstructive Surgical Procedures -- methods -- Periodicals; Fulltext; Internet Resources; Periodicals; Periodicals; 617.522
• DOI: 10.1055/s-0038-1668500
• Languages: English
• ISSNs: 1943-3875

Abstract

The purpose of this study was to compare the functional outcomes of different types of bilateral mandibular condylar fractures. This was a retrospective study of patients with bilateral mandibular condylar fractures at a level-1 trauma center over a 15-year period. The primary predictor variable was fracture pattern, classified as type I (bilateral condylar), type II (condylar–subcondylar), or type III (bilateral subcondylar). Secondary predictor variables were demographic, injury-related, and treatment factors. Bivariate associations between the predictors and complication rates were computed; a multiple logistic regression model was utilized to adjust for confounders and effect modifiers. Thirty-eight subjects with bilateral condylar injuries met the inclusion criteria. The sample's mean age was 37.6 + 18.2 years, and 16% were female. The most common mechanisms of injury were motor vehicle collisions (53%) and falls (29%). Seventy-four percent had associated noncondylar mandibular fractures, and 32% of cases had concomitant midface fractures. Fifty-three percent of cases were classified as type I, 21% as type II, and 26% as type III. Ten subjects (26%) were managed with open reduction and internal fixation. The average length of follow-up was 4.5 + 6.3 months. After adjusting for confounders and effect modifiers, the type of fracture was a significant predictor of functional complications with type II injuries having the highest likelihood of a poor functional outcome (odds ratio: 7.77, 95% confidence interval: 1.45–41.53, p = 0.02). Asymmetric bilateral mandibular condylar fractures may be associated with an increased risk of poor functional outcomes.