Quality of life in treatment of mandibular fractures using closed reduction and maxillomandibular fixation in comparison with open reduction and internal fixation – A randomized prospective study

Background Optimal treatment of displaced proximal humeral fractures is controversial. This retrospective study aims to identify complications and clinical outcomes using a locking plate with smooth pegs instead of screws (S3 plate). Method Eighty-two patients with displaced proximal humeral fracture classified with 2–4 fragments (Neer’s classification) treated with open reduction and internal fixation (ORIF) with S3 plate were studied retrospectively. Clinical outcome according to constant score; Single Shoulder Value; Disabilities of Arm, Shoulder and Hand; and European Quality of life-5 dimensions and complication rate defined radiologically including peg penetration, avascular necrosis, and loss of reduction was assessed minimum 2.5 years after surgery. Results A total of 11 peg penetrations were identified (13.6%). Avascular necrosis was seen in 8.5% (n = 7). Mean constant score at follow-up was 64.4 with a relative constant score of 87% (standard deviation 18%) compared to the contralateral uninjured side. The mean Disabilities of Arm, Shoulder and Hand score was 12.7 and mean European Quality of life-5 dimensions score 0.83. The mean Single Shoulder Value was 78.3. No cases of deep infection were seen. Conclusions Fixation with S3 plate shows a proper osteosynthesis and the functional outcome is good. Symptomatic peg penetrations are rare and the incidence is lower compared to what has been reported with locked screws.

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Prospective study of the quality of life after treatment of mandibular fractures

British Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.bjoms.2015.01.009 ◽

2015 ◽

Vol 53 (4) ◽

pp. 342-346 ◽

Cited By ~ 8

Author(s):

K.U. Omeje ◽

A.R. Adebola ◽

A.A. Efunkoya ◽

O.D. Osunde ◽

B.O. Bamgbose ◽

...

Keyword(s):

Quality Of Life ◽

Prospective Study ◽

Mandibular Fractures

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Effect Analysis of Closed Reduction and PFNA Internal Fixation for Intertrochanteric Fractures on Fracture Healing and Quality of Life of Patients

10.47939/mh.v2i12.127 ◽

2021 ◽

Keyword(s):

Quality Of Life ◽

Internal Fixation ◽

Fracture Healing ◽

Closed Reduction ◽

Intertrochanteric Fractures ◽

Effect Analysis

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Teeth in the Line of Mandibular Fractures

Canadian Journal of Plastic Surgery ◽

10.1177/229255039400200308 ◽

1994 ◽

Vol 2 (3) ◽

pp. 113-116

Author(s):

Duncan Nickerson ◽

Donald Mcphalen

Keyword(s):

Risk Factor ◽

Internal Fixation ◽

Closed Reduction ◽

Open Reduction ◽

Careful Consideration ◽

Fracture Site ◽

Fracture Line ◽

Mandibular Fractures ◽

Third Molars ◽

Infection Rates

D Nickerson, D McPhalen. Teeth in the line of mandibular fractures. Can J Plast Surg 1994;2(3):113-116. This study considers 710 mandibular fractures occurring in 546 patients over a five-year period and notes the fate of 114 teeth involved in the line of 104 of these fractures. Analysis of retention versus removal of teeth in the fracture line and any associated infection was undertaken. Overall, 15.5% of cases that involved retained teeth became infected, as compared with 7.1% of cases in which a tooth was extracted from the fracture site. for third molars, the teeth most commonly involved in mandibular fractures, infection was associated with 20.5% of retained teeth and 10% of cases where teeth were extracted from the fracture site. These data support careful consideration of a tooth's disposition before a decision regarding retention or extraction is made. Furthermore, they suggest that even in the absence of a grossly evident risk factor for infection, such as a fractured tooth, the tooth itself may inherently predispose to infection if retained. Infection rates were higher for retained teeth regardless of whether open reduction with rigid internal fixation or closed reduction with maxillomandibular fixation was used.

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Anatomic Repair vs Closed Reduction of the Syndesmosis

Foot & Ankle International ◽

10.1177/1071100721990008 ◽

2021 ◽

pp. 107110072199000

Author(s):

Al-Walid Hamam ◽

Moaz Bin Yunus Chohan ◽

Christina Tieszer ◽

Abdel-Rahman Lawendy ◽

Christopher Del Balso ◽

...

Keyword(s):

Quality Of Life ◽

Outcome Measures ◽

Closed Reduction ◽

Functional Outcomes ◽

Open Reduction ◽

Screw Fixation ◽

Secondary Outcome ◽

Level Of Evidence ◽

Significant Difference

Background: The goal of the study was to compare radiographic and functional outcomes between conventional closed syndesmotic reduction and screw fixation with open reduction, direct repair of the anterior inferior tibiofibular ligament (AiTFL) and screw fixation. We hypothesized that open reduction with restoration of the AiTFL would provide an improved reduction with better radiographic and functional outcomes. Methods: Fifty consecutive patients with OTA 44-C ankle fractures were enrolled. Treatment was nonrandomized and based on surgeon preference. Patients were treated with either open reduction, suture-anchor AiTFL repair, and screw fixation (ART group), or conventional closed reduction of the syndesmosis followed by screw fixation (CR group). The primary outcome measure was anteroposterior (AP) displacement of the fibula on CT scan at 3 months postoperatively. Secondary outcome measures included the Maryland Foot Score, the American Orthopaedic Foot & Ankle Society (AOFAS) Ankle Hindfoot Score, and the Foot and Ankle Outcome Score (FAOS). Results: Mean AP difference between injured and noninjured ankles was decreased in the ART group compared with the CR group (0.7 ± 0.3 mm vs 1.5 ± 0.3 mm, P = .008). No differences were observed between groups in overall scores for secondary outcome measures. The ART group displayed a significant difference in Maryland Foot Shoe subscore at 12 months (ART = 9.5 vs CR = 8.3, P = .03) and FAOS Quality of Life subscore at 12 months (64.1 compared to 38.3, P = .04). Conclusions: Open anatomic syndesmotic repair resulted in improved radiographic outcomes compared with closed reduction. Cosmesis was worse at 6 weeks compared to the CR group; however, quality of life and shoewear were improved in the ART group at 1 year postoperatively. Level of Evidence: Level II, prospective comparative study.

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Retromandibular Approach as a Method for Open Reduction and Internal Fixation of Mandibular Condyle Fractures. Experience in the Regional Hospital 1º de Octubre, ISSSTE and Literature Review

International Journal of Dentistry and Oral Health ◽

10.16966/2378-7090.376 ◽

2021 ◽

Vol 7 (7) ◽

Author(s):

González MGR ◽

Munguía AMN ◽

González CASJ ◽

Tellez EB ◽

Montes IDG

Keyword(s):

Internal Fixation ◽

Closed Reduction ◽

Open Reduction ◽

Surgical Techniques ◽

Mandibular Condyle ◽

Middle Cranial Fossa ◽

Sufficient Evidence ◽

Mandibular Fractures ◽

Open Treatment ◽

Condylar Fractures

Mandibular condyle fractures constitute 17.5% to 52% of mandibular fractures. Open reduction with internal fixation and closed reduction are described for their treatment. Fonseca describes the absolute indications for open treatment when there is displacement of the mandibular condyle to the middle cranial fossa, foreign body invasion, extra capsular displacement of the condyle, and/or malocclusion not susceptible to closed reduction. It includes indications with vast evidence for open treatment of bicondyle fractures, condylar displacement greater than 45 degrees, reduction in the height of the mandibular ramus greater than or equal to 2mm, fractures associated with fractures of the middle third and when there is unstable occlusion. The above establishes sufficient evidence to perform open treatment in various situations of condylar fractures. Regarding the approach of the mandibular condyle region there are different surgical techniques, such as, the preauricular, retroauricular, submandibular, retromandibular, and rhytidectomy approaches.

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Effectiveness and cost-effectiveness of primary arthrodesis versus open reduction and internal fixation in patients with Lisfranc fracture instability (The BFF Study) study protocol for a multicenter randomized controlled trial

BMC Surgery ◽

10.1186/s12893-021-01320-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

N. A. C. van den Boom ◽

G. A. N. L. Stollenwerck ◽

S. M. A. A. Evers ◽

M. Poeze

Keyword(s):

Quality Of Life ◽

Cost Effectiveness ◽

Internal Fixation ◽

Study Protocol ◽

Functional Outcomes ◽

Open Reduction ◽

Controlled Trial ◽

Optimal Treatment ◽

Fracture Dislocation

Abstract Background The Lisfranc injury is a complex injury of the midfoot. It can result in persistent pain and functional impairment if treated inappropriately. In Lisfranc fracture dislocation, treatment options are primary arthrodesis of the midfoot joints or open reduction and internal fixation. The purpose of the proposed study is to define the optimal treatment for the Lisfranc fracture dislocation, either primary arthrodesis or open reduction and internal fixation, in regard to quality of life, complications, functional outcomes, and cost effectiveness. Methods Study design: A prospective multicenter RCT. Study population: All patients of 18 years and older with an acute (< 6 weeks) traumatic fracture dislocation in the Lisfranc midfoot joints, displaced on static radiographic evaluation or unstable with dynamic evaluation, weight bearing radiographs or fluoroscopic stress testing under anesthesia, and eligible for either one of the surgical procedures. In total, this study will include n = 112 patients with Lisfranc fracture dislocation. Interventions: Patients with Lisfranc fracture dislocation will be randomly allocated to treatment in “The Better to Fix or Fuse Study” (The BFF Study) with either PA or ORIF. Main study parameters/endpoints: Primary outcome parameter: the quality of life. Secondary outcomes: complications, functional outcomes, secondary surgical interventions and cost effectiveness. Nature and extent of the burden: PA is expected to have a better outcome, however both treatments are accepted for this injury with a similar low risk of complications. Follow up is standardized and therefore this study will not add extra burden to the patient. Discussion This study protocol provides a comprehensive overview of the aims and methods of the attached clinical study. Limitations of this study are the absence of patient blinding since it is impossible in surgical intervention, and the outcome measure (AOFAS) that has limited validity not for these injuries. This study will be the first with enough power to define optimal treatment for Lisfranc fracture dislocations. This is necessary since current literature is unclear on this topic. Trial registration Current controlled Trial: NCT04519242 with registration date: 08/13/2020. Retrospectively registered; Protocol date and version: Version 4 05/06/2020

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