Rozeboom A V J, Klumpert L T, Koutris M, Dubois L, Speksnijder C M, Lobbezoo F, de Lange J
Department of Oral and Maxillofacial Surgery, Academic Medical Centre of Amsterdam, University of Amsterdam, Amsterdam, The Netherlands.
Department of Oral and Maxillofacial Surgery, University Medical Centre of Groningen, University of Groningen, Groningen, The Netherlands.
Int J Oral Maxillofac Surg. 2018 Sep;47(9):1132-1137. doi: 10.1016/j.ijom.2018.05.021. Epub 2018 Jun 13.
The treatment of mandibular condyle fractures has been the subject of considerable discussion, especially whether open or closed treatment should be used. There is a need for practical,evidence-based guidelines, and both objective and subjective parameters should be measured. To date, fewstudies have considered clinically relevant subjective parameters. This study was performed to evaluate the outcomes of the treatment of condylar fractures using the Mandibular Function Impairment Questionnaire (MFIQ) and the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and to compare the outcomes of open and the closed treatment. Patients with condylar fractures and at least 1year of follow-up were examined. These patients completed the MFIQ and other questionnaires, and were examined according to the DC/TMD. Seventy-four of 171 eligible patients participated in this study. The mean MFIQ score was 10.70 (standard error 2.9) in the open group and 4.96 (standard error 1.3) in the closed group (P=0.023), an outcome in favour of the closed treatment group. Examination according to the DC/TMD did not reveal a significant prevalence of TMD complaints. Closed treatment appears to be a safe and appropriate modality for most unilateral condylar fractures. Although the open group in general showed similar outcomes, this treatment should be reserved for limited indications.
下颌髁突骨折的治疗一直是大量讨论的主题,尤其是应采用开放治疗还是闭合治疗。需要实用的、基于证据的指南,并且应测量客观和主观参数。迄今为止,很少有研究考虑临床相关的主观参数。本研究旨在使用下颌功能损害问卷(MFIQ)和颞下颌关节紊乱病诊断标准(DC/TMD)评估髁突骨折的治疗结果,并比较开放治疗和闭合治疗的结果。对髁突骨折且至少随访1年的患者进行检查。这些患者完成了MFIQ和其他问卷,并根据DC/TMD进行检查。171例符合条件的患者中有74例参与了本研究。开放组的MFIQ平均得分为10.70(标准误2.9),闭合组为4.96(标准误1.3)(P=0.023),结果支持闭合治疗组。根据DC/TMD进行的检查未发现颞下颌关节紊乱病主诉有显著患病率。对于大多数单侧髁突骨折,闭合治疗似乎是一种安全且合适的治疗方式。尽管开放组总体上显示出相似的结果,但这种治疗应仅用于有限的适应证。