Open Treatment with Ultrasound Activated Resorbable Pins Versus Closed Treatment of Adult Mandible Condylar Head Fractures

2021 ◽  
Author(s):  
Poonam Yadav ◽  
Vidya Rattan ◽  
Sachin Rai ◽  
Satnam Singh Jolly
Keyword(s):  
Closed Treatment ◽  
Open Treatment ◽  
Condylar Head

scholarly journals Surgical Treatment of Intracapsular Condylar Head Fracture with Lag Screw Technique. A Case Report

2019 ◽  
Vol 3 (1) ◽  
pp. s-0039-1693132
Author(s):  
Rafael Zetehaku Araujo ◽  
Felipe Baires Campos ◽  
Luiz Felipe Lehman ◽  
Wagner Henriques Castro
Keyword(s):  
Surgical Treatment ◽  
Epidemiological Data ◽  
Lag Screw ◽  
Functional Aspects ◽  
Closed Treatment ◽  
Aesthetic Results ◽  
Open Treatment ◽  
Bone Fragments ◽  
Condylar Head ◽  
Condylar Fractures

Intracapsular condylar fractures may account for 65% of all condylar fractures. This diversity of classifications makes epidemiological data collection challenging. Historically, intracapsular condylar fractures were treated in a closed or conservative manner, without open surgery and fixation of the bone fragments. Closed treatment has been described with acceptable outcomes without the risk of complications associated with the surgical treatment, that is, infection, damage to the facial nerve, and unaesthetic extra-oral scar. Recently, studies reporting the surgical treatment of condylar head fractures have reported better results regarding mandibular functional aspects, dental, and aesthetic results. It is also suggested that the repositioning of the articular disc during the surgical procedure, could prevent the consequences of its displacement in possible temporomandibular joint dysfunctions. The objective of this study is to report a clinical case of intracapsular condylar head fracture with open treatment, using lag screw fixation according to AO/ASSIF (Arbeitsgemeinschaft für Osteosynthesefragen/Association for the Study of Internal Fixation) protocols and recommendations.

New Persistent Opioid Use and Associated Risk Factors Following Treatment of Ankle Fractures

2019 ◽  
Vol 40 (9) ◽  
pp. 1043-1051 ◽  
Author(s):  
Timothy D. Gossett ◽  
Fred T. Finney ◽  
Hsou Mei Hu ◽  
Jennifer F. Waljee ◽  
Chad M. Brummett ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Ankle Fracture ◽  
Opioid Use ◽  
Patient Factors ◽  
Distal Fibula ◽  
Opioid Prescription ◽  
Opioid Dose ◽  
Closed Treatment ◽  
Open Treatment

Background:The aim of this study was to define the rate of new persistent opioid use and risk factors for persistent opioid use after operative and nonoperative treatment of ankle fractures.Methods:Using a nationwide insurance claims database, Clinformatics DataMart Database, we identified opioid-naïve patients who underwent surgical treatment of unstable ankle fracture patterns between January 2009 and June 2016. Patients who underwent closed treatment of a distal fibula fracture served as a comparative group. We evaluated peritreatment and posttreatment opioid prescription fills. The primary outcome, new persistent opioid use, was defined as opioid prescription fulfillment between 91 and 180 days after the procedure. Logistic regression was used to evaluate the effect of patient factors, and the differences of the effect were tested using Wald statistics. The adjusted persistent use rates were calculated. A total of 13 088 patients underwent treatment of an ankle fracture and filled a peritreatment opioid prescription.Results:When compared with closed treatment of a distal fibula fracture, only 2 surgical treatment subtypes demonstrated significantly increased rates of persistent use compared with the closed treatment group: open treatment of bimalleolar ankle fracture (adjusted odds ratio [aOR], 1.32; 95% CI, 1.10-1.58; P = .002) and open treatment of trimalleolar ankle fracture with fixation of posterior lip (aOR, 1.47; 95% CI, 1.04-2.07; P = .027). Rates were significantly increased (aOR, 1.56; 95% CI, 1.34-1.82; P < .001) among patients who received a total peritreatment opioid dose that was in the top 25th percentile of total oral morphine equivalents. Factors independently associated with new persistent opioid use included mental health disorders, comorbid conditions, tobacco use, and female sex.Conclusion:All ankle fracture treatment groups demonstrated high rates of new persistent opioid use, and persistent use was not directly linked to injury severity. Instead, we identified patient factors that demonstrated increased risk of persistent opioid use. Limiting the peritreatment opioid dose was the largest modifiable risk factor related to new persistent opioid use in this privately insured cohort.Level of Evidence:Level III, retrospective cohort study.

scholarly journals Treatment Trends, Complications, and Effects of Comorbidities on Distal Radius Fractures

Hand ◽  
2018 ◽  
Vol 14 (4) ◽  
pp. 534-539 ◽  
Author(s):  
William P. Mosenthal ◽  
Haroutioun H. Boyajian ◽  
Sandra A. Ham ◽  
Megan A. Conti Mica
Keyword(s):  
Distal Radius ◽  
Age Groups ◽  
Distal Radius Fractures ◽  
Complication Rates ◽  
Age Group ◽  
Radius Fractures ◽  
Treatment Type ◽  
Closed Treatment ◽  
Open Treatment ◽  
The Impact

Background: Distal radius fractures (DRFs) are the most common upper extremity fractures in adults. This study seeks to elucidate the impact age, fracture type, and patient comorbidities have on the current treatment of DRFs and risk of complications. We hypothesized that comorbidities rather than age would relate to the risk of complications in the treatment of DRFs. Methods: A retrospective review of data was performed for patients treated between 2007 and 2014 using Truven Health MarketScan Research Databases. Patients who sustained a DRF were separated into “closed” versus “open” treatment groups, and the association between patient demographics, treatment type, and comorbidities with complication rates was analyzed, along with the trend of treatment modalities throughout the study time interval. Results: In total, 155 353 DRFs were identified; closed treatment predominated in all age groups with the highest percentage of open treatment occurring in the 50- to 59-year age group. Between 2007 and 2014, there was an increase in the rate of open reduction and internal fixation (ORIF) in all age groups <90 with the largest increase (11%) occurring in the 70- to 79-year age group. Higher complication rates were observed in the open treatment group in all ages <90 years with a trend toward decreasing complication rates as age increased. Comorbidities were more strongly associated with the risk of developing complications than age. Conclusions: Closed treatment of DRFs remains the predominant treatment method among all age groups, but DRFs are increasingly being treated with ORIF. Emphasis on the patients’ comorbidities rather than chronological age should be considered in the treatment decision-making process of elderly patients with DRFs.

scholarly journals Current Opinions on Surgical Treatment of Fractures of the Condylar Head

2014 ◽  
Vol 7 (2) ◽  
pp. 92-100 ◽  
Author(s):  
Paolo Boffano ◽  
Rodolfo Benech ◽  
Cesare Gallesio ◽  
Francesco Arcuri ◽  
Arnaldo Benech
Keyword(s):  
Surgical Treatment ◽  
Temporomandibular Joint ◽  
Current Knowledge ◽  
Mandibular Condyle ◽  
Bone Screws ◽  
Functional Movement ◽  
Anatomical Position ◽  
Open Treatment ◽  
Condylar Head

Treatment of mandibular condyle fractures is still controversial, with surgical treatment slowly becoming the preferred option. However, fractures of the condylar head (diacapitular fractures) are still treated conservatively at many institutions. Recently, more and more surgeons have begun to perform open treatment for diacapitular fractures because it allows to restore the anatomical position of the fragments and disc, it allows an immediate functional movement of the jaw, and avoid the ankylosis of the temporomandibular joint induced by the trauma. Several techniques have been proposed to reduce and fix fractures of the condylar head, such as standard bone screws, resorbable screws, resorbable pins, and cannulated lag screws. Therefore, the aim of this article is to review the literature about the surgical treatment of fractures of the condylar head to resume the current knowledge about open treatment of such fractures.

Clinical outcomes of open treatment of old condylar head fractures in adults

2021 ◽  
Author(s):  
Xueting Luo ◽  
Ruiye Bi ◽  
Nan Jiang ◽  
Songsong Zhu ◽  
Yunfeng Li
Keyword(s):  
Clinical Outcomes ◽  
Open Treatment ◽  
Condylar Head

scholarly journals A Comparative Evaluation of Closed and Open Treatment in the Management of Unilateral Displaced Mandibular Subcondylar Fractures: A Prospective Randomized Study

2018 ◽  
Vol 11 (3) ◽  
pp. 205-210 ◽  
Author(s):  
Virendra Singh ◽  
Neeraj Kumar ◽  
Amrish Bhagol ◽  
Neha Jajodia
Keyword(s):  
Treatment Options ◽  
Randomized Study ◽  
Mouth Opening ◽  
Treatment Results ◽  
Treatment Groups ◽  
Advantages And Disadvantages ◽  
Closed Treatment ◽  
Significant Difference ◽  
Open Treatment

The aim of the study is to evaluate closed and open treatment in the management of unilateral displaced mandibular subcondylar fractures. Twenty patients with unilateral subcondylar fractures of the mandible were evaluated with degree of displacement of more than 20 degrees and ramal height shortening of more than 10 mm. They were informed of the need for 6-month follow-up. Patients were thoroughly informed, explaining the possible advantages and disadvantages of the open and closed treatment options. Radiographic parameters included the level of fracture, deviation of fragment, and ramal height shortening. Correct anatomical reduction is achieved by open treatment as compared with closed treatment. Regarding pain, mouth opening, and lateral excursion movement, statistically significant difference was found in both groups ( p < 0.01). In radiographic assessment of ramal height shortening and fracture displacement, statistically significant difference was found ( p < 0.01). And no significant complication is found in both treatment groups. The results of this study favor the open treatment for the management of displaced subcondylar fractures. However, the treatment results are also acceptable for closed group.

scholarly journals Minimal bone resorption after open treatment of mandibular condylar head fractures

2021 ◽  
Author(s):  
Michael-Tobias Neuhaus ◽  
Nils-Claudius Gellrich ◽  
Alexander-Nicolai Zeller ◽  
Alexander Karl-Heinz Bartella ◽  
Anna Katharina Sander ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Bone Resorption ◽  
Open Reduction ◽  
Cone Beam ◽  
Clinical Parameters ◽  
Osteosynthesis Material ◽  
Open Treatment ◽  
Condylar Head

Abstract Open treatment of condylar base and neck fractures is widely recommended, whereas treatment of condylar head fractures is still controversial and just is removal of osteosynthesis material. In this study, bone resorption and remodelling after open treatment of condylar head fractures were three-dimensionally (3D) assessed and correlated with clinical parameters in a medium follow-up. Of 18 patients with 25 condylar head fractures who underwent open reduction and internal fixation, clinical data and cone beam computed tomography (CBCT) datasets were analysed. Condylar processes were segmented in the postoperative and follow-up CBCT scans. Volumetric and linear changes were measured using a sophisticated 3D-algorithm. In the course after surgery, patients function and pain improved significantly. Low rates of postoperative complications were observed. All 3D measurements showed no significant bone resorption during the follow-up period. Open reduction of condylar head fractures leads to good patients outcomes and low rates of long-term complications. This study underlines the feasibility and importance of open treatment of condylar head fractures and may help to spread its acceptance as the preferred treatment option.

Ankle Fractures

Foot & Ankle ◽  
1987 ◽  
Vol 8 (1) ◽  
pp. 23-25 ◽  
Author(s):  
Mats Bauer ◽  
Olof Johnell ◽  
Inga Redlund-Johnell ◽  
Kjell Johnsson
Keyword(s):  
Ankle Fracture ◽  
Clinical Information ◽  
Ankle Fractures ◽  
Closed Treatment ◽  
Open Treatment

The results of three separate studies on ankle fractures are presented. Clinical information is provided concerning the epidemiology and a comparison of closed versus open treatment, and a discussion is presented concerning what results can be expected 30 years after closed treatment for an ankle fracture.

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