Resident, Oral and Maxillofacial Surgery, Emory University School of Medicine, Atlanta, GA.
Assistant Professor, Department of Biomedical Sciences, School of Dentistry, Texas A & M University, Dallas, TX.
J Oral Maxillofac Surg. 2023 Feb;81(2):184-193. doi: 10.1016/j.joms.2022.10.006. Epub 2022 Oct 19.
There is no consensus in mandibular condylar fracture/s treatment. In medicine, quality of life (QOL) includes the individual's satisfaction toward their own health condition, disease, or treatment. The purpose of this study was to investigate self-perception QOL outcomes for patients who sustained mandibular condylar fracture/s.
This cross-sectional study surveyed patients at Grady Memorial Hospital in Atlanta, Georgia from November 2016 to June 2020. The study included patients who were at least 16 years old at the time of injury, diagnosed with mandibular condylar fracture/s, treated by close reduction or open reduction and internal fixation (ORIF), presented for 6-months post-operative follow-up, and had a valid phone number. The primary predictor variable was treatment approach. The primary outcome variable was mood. Covariates were demographics, injury details, and self-perception QOL questionnaire. Univariate, bivariate, and ordinal regression analysis were performed (P < .05 significance).
A total of 108 patients met inclusion criteria. Response rate was 84.2%. Our data showed that patients who underwent ORIF treatment were statistically more likely to experience no or milder pain when chewing (tau = 0.390, P = .002), to not require pain medications (tau = 0.389, P = .002), to report larger maximum mouth opening (tau = 0.402, P = .0003), and to report better QOL (tau = 0.440, P = 7.407e-05). Ordinal regression analysis showed that patients who had undergone ORIF treatment were positively associated with better mood (estimate: -0.062; OR: 0.54; P = .29) and statistically significant associated with excellent QOL (estimate: -2; OR: 0.13; P = 3.99e-05). Patients who sustained class III Lindahl mandibular condyle fracture were statistically significantly associated with depressed mood (estimate: 1.46; OR: 4.33; P = .002).
ORIF treatment was positively associated with better QOL when compared to closed reduction for mandibular condyle fracture.
下颌骨髁突骨折/脱位的治疗方法尚未达成共识。在医学领域，生活质量（QOL）包括个人对自身健康状况、疾病或治疗的满意度。本研究旨在调查下颌骨髁突骨折/脱位患者的自我感知 QOL 结果。
本横断面研究调查了 2016 年 11 月至 2020 年 6 月期间在佐治亚州亚特兰大市 Grady Memorial 医院就诊的患者。研究纳入了至少 16 岁、损伤时诊断为下颌骨髁突骨折/脱位、接受闭合复位或切开复位内固定（ORIF）治疗、术后 6 个月接受随访且有有效电话号码的患者。主要预测变量为治疗方法，主要结局变量为情绪。协变量包括人口统计学、损伤细节和自我感知 QOL 问卷。进行了单变量、双变量和有序回归分析（P<.05 有统计学意义）。
共有 108 名患者符合纳入标准，应答率为 84.2%。我们的数据显示，接受 ORIF 治疗的患者在咀嚼时出现无或轻度疼痛的可能性更大（tau=0.390，P=.002），不需要使用止痛药（tau=0.389，P=.002），最大张口度更大（tau=0.402，P=.0003），生活质量更好（tau=0.440，P=7.407e-05）。有序回归分析表明，接受 ORIF 治疗的患者与更好的情绪（估计值：-0.062；OR：0.54；P=.29）呈正相关，与优秀的 QOL 呈统计学显著相关（估计值：-2；OR：0.13；P=3.99e-05）。发生 III 型 Lindahl 下颌骨髁突骨折的患者与抑郁情绪呈统计学显著相关（估计值：1.46；OR：4.33；P=.002）。
与闭合复位相比，ORIF 治疗下颌骨髁突骨折与更好的 QOL 呈正相关。
