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What is the evidence for open versus closed treatment of mandibular condylar fractures in adults?
Author(s) -
Khelemsky Renata,
Moubayed Sami P.,
Buchbinder Daniel
Publication year - 2016
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.26076
Subject(s) - medicine , condyle , orthodontics , dentistry
BACKGROUND The decision to treat adult condylar fractures through closed or open techniques is one of the greatest debates within maxillofacial trauma. This controversy stems from the complexity of biomechanical principles of the posttraumatic temporomandibular joint (TMJ). Closed treatment (CTr) restores occlusion but does not anatomically reduce fractured segments and involves maxillo-mandibular fixation with functional therapy. Closed treatment has become a popular choice due to largely satisfactory clinical data and low surgical risk; however, complications of varying severity are reported. On the other hand, open surgical treatment increases risk of facial nerve damage and scarring. Much of the published data lacks consistency in study design, selection criteria, outcome measures, follow-up, and ultimately detection of complications. Biased interpretation of such data precludes a clear treatment strategy. What exactly is the evidence for open versus closed treatment of adult condylar fractures?