1. Does Fracture Pattern Influence Functional Outcomes in the Management of Bilateral Mandibular Condylar Injuries?
- Author
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Alexandra Macmillan, Amir H. Dorafshar, Paul N. Manson, Gerhard S. Mundinger, Howard D. Wang, Arthur J. Nam, Srinivas M. Susarla, Robin Yang, Benjamin D. Schultz, and Abhishake Banda
- Subjects
business.industry ,medicine.medical_treatment ,Trauma center ,Confounding ,Dentistry ,Retrospective cohort study ,Odds ratio ,Condyle ,Confidence interval ,stomatognathic system ,Otorhinolaryngology ,Medicine ,Internal fixation ,Surgery ,Oral Surgery ,business ,Complication - 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.
- Published
- 2019