Introduction
Materials and methods
Study population
Fracture reduction techniques and surgery
Study variables and outcome measurements
Statistical analysis
Results
General characteristics of patients
Patient characteristics and reduction techniques
Reduction not aided by the forceps (n = 54)a | Reduction aided by the forceps (n = 77)a | P valuec | ||
---|---|---|---|---|
Age (mean ± SD) | 33.0 ± 16.4 | 32.9 ± 16.7 | .687* | |
Number of fractures (mean ± SD) | 1.9 ± 0.7 | 1.8 ± 0.7 | .186* | |
Gender (n = 131) | Male | 43 (80) | 60 (78) | .496 |
Female | 11 (20) | 17 (22) | ||
Smoking (n = 131) | No | 49 (91) | 64 (83) | .161 |
Yes | 5 (9) | 13 (17) | ||
Oral hygiene (n = 120) | Good | 44 (92) | 66 (92) | .638 |
Poor | 4 (8) | 6 (8) | ||
Comorbidity (n = 131) | No | 45 (83) | 73 (95) | .039 |
Yes | 9 (17) | 4 (5) | ||
Dental status (n = 131) | Complete | 37 (69) | 45 (58) | .156 |
Partially | 11 (20) | 27 (35) | ||
Edentulous | 6 (11) | 5 (7) | ||
Fracture type (n = 131) | Single fracture | 19 (35) | 17 (22) | .432 |
Single fracture concomitant condyle (unilateral or bilateral) | 14 (26) | 24 (31) | ||
Bilateral or unilateral double fracture | 19 (35) | 32 (42) | ||
Bilateral fracture concomitant condyle (unilateral or bilateral)) | 2 (4) | 4 (5) | ||
Complication | No | 39 (72) | 71 (92) | .005 |
Minor | 10 (19) | 3 (4) | ||
Major | 5 (9) | 3 (4) |
Fracture characteristics and reduction techniques
Variables | Open treatment and internal fixation (n = 179) | Closed (n = 73) | P valuec | ||
---|---|---|---|---|---|
Reduction not aided by the forceps (n = 90)a | Reduction aided by forceps (n = 89)a | No reduction (n = 73)a | |||
Fracture locations (n = 252) | (Para)symphysesal | 16 (18) | 51 (57) | 0 | .001 |
Body | 26 (29) | 28 (32) | 0 | ||
Angle | 37 (41) | 10 (11) | 0 | ||
Ramus | 2 (2) | 0 | 21 (29) | ||
Condyle | 9 (10) | 0 | 52 (71) | ||
Fracture type (n = 252) | Simple | 74 (82) | 69 (78) | 64 (87) | .001 |
Comminuted | 16 (18) | 20 (22) | 1 (2) | ||
Incomplete | 0 | 0 | 8 (11) | ||
Fracture fixation (n = 178)b | Load sharing | 82 (91) | 76 (85) | .466 | |
Load bearing | 2 (2) | 4 (5) | |||
Both | 6 (7) | 9 (10) | |||
Complications (n = 252) | No | 75 (83) | 83 (93) | 73 (100) | .001 |
Yes | 15 (17) | 6 (7) | 0 |
Complications | Open treatment and internal fixation (n = 179) | Closed (n = 73) | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Reduction not aided by the forceps (n = 90) | Reduction aided by forceps (n = 89) | No reduction (n = 79) | |||||||||||
(Para)symphyseal | Body | Angle | Ramus | Condyle | (Para)symphyseal | Body | Angle | Ramus | Condyle | Ramus | Condyle | ||
No | 13 (82) | 20 (77) | 31 (83) | 2 (100) | 9 (100) | 50 (98) | 27(96) | 6 (60) | 0 | 0 | 0 | 0 | |
Minor | Infections | 0 | 3 (11) | 3 (8) | 0 | 0 | 0 | 0 | 1 (10) | ||||
Poor occlusion needs elastic traction | 1 (6) | 1 (4) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1* | 3* | |
Asymptomatic plate fracture | 0 | 0 | 1 (3) | 0 | 0 | 0 | 0 | 2 (20) | 0 | 0 | 0 | 0 | |
Periapical radiolucency due to IMF screw | 0 | 0 | 1 (3) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | |
Major | Insufficient reduction | 1 (6) | 2 (8) | 1 (3) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Lingual flaring | 1 (6) | 0 | 0 | 0 | 0 | 1 (2) | 1 (4) | 0 | 0 | 0 | 0 | 0 | |
Non-union | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 (10) | 0 | 0 | 0 | 0 |
Confounders
OR (CI 95%) | P value | ||
---|---|---|---|
Unit of analysis number of patients | |||
Age | 1.0 (0.9–1.0) | .927 | |
Gender (male, female) | 2.1 (0.7–5.9) | .151 | |
Comorbidity (no, yes) | 0.9 (0.1–4.6) | .947 | |
Smoking (no, yes) | 0.6 (0.1–2.9) | .544 | |
Oral hygiene (good, poor) | 1.2 (0.2–6.5) | .768 | |
Dental status | Complete | Reference | |
Partially | 1.5 (0.5–4.1) | .382 | |
Edentulous | 0.5 (0.6–4.9) | .622 | |
Velocity of fracturea (high, low) | 1.6 (0.5–4.4) | .364 | |
Condyle fracture (with, without) | 0.5 (0.1–1.6) | .305 | |
Fracture | Single | Reference | |
Single condyle | 0.4 (0.1–1.5) | .412 | |
Bilateral | 0.6 (0.2–1.9) | .440 | |
Bilateral condyle | 0.7 (0.0–6.8) | .760 | |
Reduction techniques | Forceps aided | Reference | |
Non-forceps aided | 4.5 (1.6–12.6) | .004 | |
Unit of analysis number of fracturesb | |||
Location | (Para)symphyseal | Reference | |
Body | 2.3 (0.6–8.4) | .194 | |
Angle | 4.2 (1.2–14.5) | .021 | |
Fracture type | Simple | Reference | |
Comminuted | 0.9 (0.2–3.3) | .900 | |
Incomplete | 0.0 | .999 | |
Fixation | Load sharing | Reference | |
Load bearing | 0.0 | .999 | |
Both | 0.4 (0.6–3.9) | .505 | |
Reduction techniques | Forceps aided | Reference | |
Non-forceps aided | 2.7 (1.0–7.4) | .045 |