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Can dynamic elastic therapy be established as the standard protocol of closed reduction for moderately displaced extracapsular condylar fractures?

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Abstract

Objective

This study was conducted with the aim to establish standard technique of closed reduction (CR) and compare functional outcomes in patients of moderately displaced unilateral extracapsular condylar fractures.

Material and methods

This study is a retrospective randomized controlled trial, conducted at a tertiary care hospital setting from August, 2013 to November, 2018. Patients of unilateral extracapsular condylar fractures with ramus shortening < 7mm and deviation < 35° were divided in two groups by drawing lots and were treated by dynamic elastic therapy and maxillomandibular fixation (MMF). Mean and standard deviation were calculated for quantitative variables, and one way analysis of variance (ANOVA) and Pearson’s Chi-square test were used to determine significance of outcomes between two modalities of CR. P value < 0.05 was taken as significant.

Results

The numbers of patients treated by dynamic elastic therapy and MMF were 76 (38 in each group). Out of which 48 (63.15%) were male and 28 (36.84%) were female. The ratio of male to female was 1.7:1. The mean ± standard deviation (SD) of age was 32 ± 9.57 years. In patients treated by dynamic elastic therapy, the mean ± SD (at 6-month follow-up) of loss of ramus height (LRH), maximum incisal opening (MIO) and opening deviation were 4.6mm ± 1.08mm, 40.4mm ± 1.57mm and 1.1mm ± 0.87mm respectively. Whereas, LRH, MIO and opening deviation were 4.6mm ± 0.85mm, 40.4mm ± 2.37mm and 0.8mm ± 0.63mm respectively by MMF therapy. One-way ANOVA was statistically insignificant (P value > 0.05) for above mentioned outcomes. Pre-traumatic occlusion was achieved in 89.47% of patients by MMF and in 86.84% patients by dynamic elastic therapy. Pearson’s Chi-square test was statistically insignificant (p value < 0.05) for occlusion.

Conclusion

Parallel results were obtained for both modalities; thus, the technique as dynamic elastic therapy, which promotes early mobilization and functional rehabilitation, can be favored as standard technique of closed reduction for moderately displaced extracapsular condylar fractures. This technique eases patients’ stress associated with MMF and prevents ankylosis.

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Authors and Affiliations

  1. Dental College, Lahore Medical & Dental College, Lahore, Pakistan

    Aqib Sohail

  2. Department of Oral & Maxillofacial Surgery, Lahore Medical & Dental College, Lahore, Pakistan

    Fareed ud din Ahmad Chishti, Nighat Zahid & Tayyaba Rafiq

  3. Department of Oral & Maxillofacial Surgery, Rashid Latif Dental College/Rashid Latif Medical Complex, Lahore, Pakistan

    Saadia Manzar

  4. Department of Oral Medicine, CMH Lahore Medical College & Institute of Dentistry, National University of Medical Sciences, Rawalpindi, Pakistan

    Fareed Ahmad

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  4. Nighat Zahid
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Contributions

All authors contributed to study conception and design. Material preparation and data collection were performed by FAC, FA and TR. Data analysis and first draft of manuscript was written by SM. Critical review was done by AS and NZ. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Saadia Manzar.

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This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Lahore Medical & Dental College (reference no. LMDC/FD/1826/12).

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Written informed consent was obtained from all individual participants included in the study.

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This study does not contain any individual person’s data in any form (including individual details, images or videos).

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The authors declare no competing interests.

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Sohail, A., Chishti, F.u.d.A., Manzar, S. et al. Can dynamic elastic therapy be established as the standard protocol of closed reduction for moderately displaced extracapsular condylar fractures?. Oral Maxillofac Surg 28, 385–391 (2024). https://doi.org/10.1007/s10006-023-01154-6

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