Three-dimensional assessment of unilateral subcondylar fracture using computed tomography after open reduction.

OBJECTIVE: The aim was to assess the accuracy of three-dimensional anatomical reductions achieved by open method of treatment in cases of displaced unilateral mandibular subcondylar fractures using preoperative (pre op) and postoperative (post op) computed tomography (CT) scans. MATERIALS AND METHODS: In this prospective study, 10 patients with unilateral sub condylar fractures confirmed by an orthopantomogram were included. A pre op and post op CT after 1 week of surgical procedure was taken in axial, coronal and sagittal plane along with three-dimensional reconstruction. Standard anatomical parameters, which undergo changes due to fractures of the mandibular condyle were measured in pre and post op CT scans in three planes and statistically analysed for the accuracy of the reduction comparing the following variables: (a) Pre op fractured and nonfractured side (b) post op fractured and nonfractured side (c) pre op fractured and post op fractured side. P < 0.05 was considered as significant. RESULTS: Three-dimensional anatomical reduction was possible in 9 out of 10 cases (90%). The statistical analysis of each parameter in three variables revealed (P < 0.05) that there was a gross change in the dimensions of the parameters obtained in pre op fractured and nonfractured side. When these parameters were assessed in post op CT for the three variables there was no statistical difference between the post op fractured side and non fractured side. The same parameters were analysed for the three variables in pre op fractured and post op fractured side and found significant statistical difference suggesting a considerable change in the dimensions of the fractured side post operatively. CONCLUSION: The statistical and clinical results in our study emphasised that it is possible to fix the condyle in three-dimensional anatomical positions with open method of treatment and avoid post op degenerative joint changes. CT is the ideal imaging tool and should be used on a regular basis for cases of condylar fractures.

A Clinician's Role in the Management of Soft Tissue Injuries of the Face: A Clinical Paper.

INTRODUCTION: Injuries of the facial soft tissues may be due to road traffic accidents, industrial injuries, domestic and interpersonal violence, dog bites, human bites, war injuries etc. They may be described depending on the depth of involvement of the soft tissue and/or region since it gives the clinician the method of treatment. The soft tissue injuries must take into the underlying skeletal injury into account since these injuries if carelessly handled they leave deformed scarring in the most precious and beautiful part of the body. MATERIALS AND METHODS: Various patients reporting to the department of Oral and Maxillofacial Surgery, Narayana Dental College and hospital, Nellore were included in the study. Injuries in the various aspects of face at various anatomical areas has been presented with the mode of management. CONCLUSION: The maxillofacial surgeon while attending these cases should avoid the need for revision by having a thorough knowledge of the anatomy, physiology of the soft tissues and treat them accordingly after following good clinical and radiological examination.