TY - JOUR
T1 - Open or closed repositioning of mandibular fractures
T2 - is there a difference in healing outcome? A systematic review
AU - Andreasen, Jens Ove
AU - Storgård Jensen, Simon
AU - Kofod, Thomas
AU - Schwartz, Ole
AU - Hillerup, Sören
PY - 2008/2
Y1 - 2008/2
N2 - The clinical outcome of closed vs open reduction and rigid fixation was compared based on a systematic review of the literature. Ten non-randomized retrospective studies were found. In six of these ten studies, the complication rate was significantly increased when open reduction and plating was performed. In the remaining studies, a slightly elevated (but not significant) infection rate was found when compared with closed reduction. Altogether, an infection rate of 5.0% was found in the closed reduction group whereas 10.6% and 14.6% were found when open reduction was performed using either plates or wires. Nerve injuries were slightly increased when open reduction was found (although not significant). With regard to occlusal disturbances, no difference was found in the open and closed reduction group. Concerning overall complication problems, six of seven studies showed more problems after open than closed reduction. In conclusion, this literature review using retrospective studies has raised doubts regarding the superiority of open reduction and rigid splinting, compared to closed reduction and intermaxillary splinting. However, a bias concerning the preferential use of open reduction in case of more complicated fractures cannot be excluded, which might explain the differences found between the two procedures. Prospective, randomized clinical trials are needed to illuminate this problem.
AB - The clinical outcome of closed vs open reduction and rigid fixation was compared based on a systematic review of the literature. Ten non-randomized retrospective studies were found. In six of these ten studies, the complication rate was significantly increased when open reduction and plating was performed. In the remaining studies, a slightly elevated (but not significant) infection rate was found when compared with closed reduction. Altogether, an infection rate of 5.0% was found in the closed reduction group whereas 10.6% and 14.6% were found when open reduction was performed using either plates or wires. Nerve injuries were slightly increased when open reduction was found (although not significant). With regard to occlusal disturbances, no difference was found in the open and closed reduction group. Concerning overall complication problems, six of seven studies showed more problems after open than closed reduction. In conclusion, this literature review using retrospective studies has raised doubts regarding the superiority of open reduction and rigid splinting, compared to closed reduction and intermaxillary splinting. However, a bias concerning the preferential use of open reduction in case of more complicated fractures cannot be excluded, which might explain the differences found between the two procedures. Prospective, randomized clinical trials are needed to illuminate this problem.
KW - Fracture Fixation, Internal/methods
KW - Fracture Healing/physiology
KW - Humans
KW - Jaw Fixation Techniques
KW - Mandibular Fractures/surgery
KW - Postoperative Complications
KW - Retrospective Studies
KW - Treatment Outcome
U2 - 10.1111/j.1600-9657.2006.00498.x
DO - 10.1111/j.1600-9657.2006.00498.x
M3 - Review
C2 - 18173659
SN - 1600-4469
VL - 24
SP - 17
EP - 21
JO - Dental Traumatology
JF - Dental Traumatology
IS - 1
ER -