Closed versus open treatment of mandibular condylar process fractures: A meta-analysis of retrospective and prospective studies

J Craniomaxillofac Surg. 2015 Oct;43(8):1404-8. doi: 10.1016/j.jcms.2015.07.027. Epub 2015 Aug 4.

Abstract

Introduction: The treatment of fractures of the mandibular process remains controversial, although there is a trend towards open reduction and internal fixation. This study compared open and closed treatments and assessed the results with a meta-analysis.

Materials and methods: A literature search of PubMed found eight studies that met the search criteria and were included in the meta-analysis.

Results: The studies increasingly suggest better results for open treatment, in terms of mouth opening, protrusion, laterotrusion, pain, and malocclusion. In the meta-analysis, the outcome was significantly better for laterotrusion and protrusion in patients treated by open reduction and internal fixation.

Conclusion: Due to the different study protocols and lack of information on classification, follow-up time, and inclusion criteria, comparison of the studies remains difficult and further prospective, randomized studies should examine these issues.

Keywords: Closed treatment; Mandibular condylar fracture; Meta-analysis; Open treatment.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Closed Fracture Reduction / methods*
  • Fracture Fixation, Internal / methods
  • Humans
  • Mandibular Condyle / injuries*
  • Mandibular Fractures / surgery
  • Mandibular Fractures / therapy*
  • Open Fracture Reduction / methods*
  • Prospective Studies
  • Range of Motion, Articular / physiology
  • Retrospective Studies
  • Treatment Outcome