Condyle head fracture management: A systematic review of outcomes

IF 2.1 2区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Cranio-Maxillofacial Surgery Pub Date : 2024-12-01 DOI:10.1016/j.jcms.2024.08.019

Chiew Ying Chieng , Anika Patel , Hira Nazir , Sana Ali , Nabeel Bhatti , Niall Mcleod

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引用次数: 0

Abstract

The management of Condylar Head fractures (CHFs) has historically been with closed treatments(CTR); however, contemporary studies suggest that Open Reduction and Internal Fixation(ORIF) may produce better clinical and radiographic results. Our primary aim was to review the literature on the clinical and radiological outcomes of open and closed management of CHFs.

A systematic literature search was undertaken using EMBASE, MEDLINE and PubMed, using PRISMA guidelines, for all studies relating to outcomes following CHF. The inclusion criteria include 1) studies focused on CHF in adult patients that included at least 20 cases 2) published in English language. ROBINS-1 tool was used for risk assessment. Data extracted was analysed and compared using the relative risks.

A total of 29 studies reporting on 1550 ORIF and 798 CTR were included. ORIF resulted in significantly less trismus (RR 9.5), chin deviation (RR 7.3), malocclusion (RR 6.5), TMJ clicking (RR 4.3) and pain(RR 12.6) than CTR.

Due to the substantial heterogeneity of studies, firm conclusions are difficult but there does appear to be objective benefits in outcomes following ORIF than CTR. Satisfactory results may however be achieved with CTR. Further large studies using standardised outcome measurements will be required to help elucidate exactly which CHF are best served by ORIF.

查看原文本刊更多论文

髁头骨折处理：疗效系统回顾。

髁状头骨折（CHFs）的治疗历来采用闭合治疗（CTR），但当代研究表明，切开复位内固定术（ORIF）可能会产生更好的临床和影像学效果。我们的主要目的是回顾有关CHFs开放式和闭合式治疗的临床和放射学结果的文献。我们使用EMBASE、MEDLINE和PubMed，按照PRISMA指南对所有与CHF术后效果相关的研究进行了系统性文献检索。纳入标准包括：1）以成人患者的慢性心力衰竭为研究对象，至少包含 20 个病例；2）以英语发表。采用 ROBINS-1 工具进行风险评估。采用相对风险对提取的数据进行分析和比较。共纳入了 29 项研究，报告了 1550 例 ORIF 和 798 例 CTR。与 CTR 相比，ORIF 所导致的三叉症（RR 9.5）、下巴偏斜（RR 7.3）、咬合不正（RR 6.5）、颞下颌关节咔哒声（RR 4.3）和疼痛（RR 12.6）明显减少。由于研究结果存在很大的异质性，因此很难得出确切的结论，但与 CTR 相比，ORIF 的治疗效果似乎确实有客观的优势。不过，CTR也可能取得令人满意的结果。需要进一步开展使用标准化结果测量的大型研究，以帮助明确哪些CHF最适合接受ORIF治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cranio-Maxillofacial Surgery 医学-外科

CiteScore

5.20

自引率

22.60%

发文量

117

审稿时长

70 days

期刊介绍： The Journal of Cranio-Maxillofacial Surgery publishes articles covering all aspects of surgery of the head, face and jaw. Specific topics covered recently have included: • Distraction osteogenesis • Synthetic bone substitutes • Fibroblast growth factors • Fetal wound healing • Skull base surgery • Computer-assisted surgery • Vascularized bone grafts