2017-18 HSC Section 3 Green Book

ORIGINAL ARTICLE

Kotrashetti, Lingaraj and Khurana e9

Volume 115, Number 4

Table IV. Distribution of study samples according to groups and maximal interincisal opening at 3 and 6 months’ follow-up

3 mo

6 mo

Groups

Inadequate ( 40 mm)

Adequate ( 40 mm)

Inadequate ( 40 mm)

Adequate ( 40 mm)

Group I: closed reduction Group II: open reduction

7 (58.3%)

5 (41.7%)

5 (41.7%)

7 (58.3%)

2 (20%)

8 (80%)

1 (10%)

9 (90%)

Yates corrected chi-square 1.9201; P

.1660

Yates corrected chi-square 1.3921; P

.2380

Table V. Distribution of study samples according to groups and facial nerve function at 3 and 6 months’ follow-up

3 mo

6 mo

Groups

Lost

Preserved

Lost

Preserved

Group I: closed reduction Group II: open reduction

0 (0%) 1 (10%)

12 (100%)

0 (0%) 1 (10%)

12 (100%)

9 (90%)

9 (90%)

Yates corrected chi-square .0091; P .9260

Yates corrected chi-square .0091; P .9260

Table VI. Comparison of group I and group II regard- ing posterior ramal height (measured using OPG, in mm) at normal side, fracture side after 3 months, and fracture side after 6 months by t test

Table VII. Comparison of group I and group II regard- ing distance of the condyle from the midline (measured using PA mandible, in mm) at normal side, fracture side after 3 months, and fracture side after 6 months by t test

P value

P value

Variable

Group Mean SD t Value

Variable

Group Mean SD t value

Table V presents the distribution of study samples according to groups and facial nerve function at 3 and 6 months’ follow-up. Facial nerve function was pre- served in 100% of the patients in group I, whereas it was lost in 10% of the patients treated by open reduc- tion. 2 test was statistically significant at both 3 and 6 months’ follow-up. Table VI presents the comparison of group I and group II regarding posterior ramal height (measured with OPG, in mm) at normal side, fracture side after 3 months, and fracture side after 6 months by t test. Mean posterior ramal heights when measured with OPG after 3 months were 66.08 6.28 and 70.50 2.50 in groups I and II, respectively ( P .04). After 6 months, the means of groups I and II were 65.33 5.91 and 70.50 2.50, respectively ( P .02). When t test was done, the results obtained were statistically significant at both 3 and 6 months’ of follow-up. Table VII presents the comparison of group I and group II regarding distance of the condyle from the midline (measured using PA mandible, in mm) at nor- mal side, fracture side after 3 months, and fracture side after 6 months by t test. Mean distances of condyle from center when measured using a PA view after 3 months were 51.50 4.54 and 53.00 2.66 in groups Group I 71.6667 5.5487 .4513 .6566 Group II 70.8000 2.6583 Fracture—3 mo Group I 66.0833 6.2879 2.0810 .0499* Group II 70.5000 2.5055 Fracture—6 mo Group I 65.3333 5.9135 2.5692 .0183* Group II 70.5000 2.5055 * P .05. Normal side

I and II, respectively ( t .037). After 6 months, the means of groups I and II were 51.33 4.29 and 53.00 2.66, respectively ( t 1.07; P .29). When t test was done, the results obtained were statisti- cally insignificant in both 3 and 6 months’ follow up. DISCUSSION A patient who has had a condylar fracture cannot be considered to be cured until he is able to masticate easily with the contralateral side of the dentition, which implies the recovery of the condylar excursion. 6 There are few aspects of maxillofacial trauma management that generate more controversy than the management of a fracture involving the condylar process of the man- dible. Traditionally managed by closed treatment meth- ods, this type of fracture has not escaped the attention of clinicians attempting to achieve improved and more predictable outcomes by techniques of ORIF. 7 Conser- vative treatment of condylar fractures in both young people and adults has long been the method of choice. The reason for adopting a less aggressive surgical ap- proach is the difficulty in manipulating the fragments in a small area with risk of damaging the facial nerve or vessels such as the internal maxillary artery. 7 As long ago as 1925, Silverman 8 described the first method of Group I 52.5833 4.7378 0.3037 .7645 Group II 53.1000 2.7669 Fracture—3 mo Group I 51.5000 4.5427 0.9184 .3693 Group II 53.0000 2.6667 Fracture—6 mo Group I 51.3333 4.2923 1.0660 .2991 Group II 53.0000 2.6667 .91; P Normal side

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