KẾT QUẢ ĐIỀU TRỊ GÃY CỔ LỒI CẦU VÀ DƯỚI LỒI CẦU XƯƠNG HÀM DƯỚI DO CHẤN THƯƠNG TẠI BỆNH VIỆN HỮU NGHỊ VIỆT ĐỨC

Abstract

Objective: This study aims to describe the clinical characteristics, radiographic, and treatment outcomes of closed treatment (CT) and open reduction and internal fixation (ORIF) in patients with mandibular condyle neck and subcondylar fractures due to trauma at Viet Duc University Hospital. Materials and Methods: A cross – sectional study was conducted on 61 patients diagnosed with condylar neck and subcondylar fractures who received treatment at Viet Duc University Hospital between January 2023 and August 2024. Results: The male – to – female ratio was 2.6:1, with the majority of cases (83.6%) occurring in the 18 – 39 age group. The predominant cause of injury was traffic accidents, accounting for 85.2% of cases. The most frequently observed clinical symptoms included sharp pain in the preauricular region (98.4%) and malocclusion (96.7%). Limited mouth opening was observed in 98.4% of cases, with a maximal interincisal opening (MIO) of <30 mm. The incidence of condylar neck fractures (49.2%) and subcondylar fractures (50.8%) was nearly equal. Treatment selection was based on the degree of fracture displacement (Bhagol classification): all patients with Class I fractures underwent CT; Class II fractures were predominantly managed with CT (77.3%); and Class III fractures were primarily treated with ORIF (87.5%). Regarding treatment outcomes, patients with Class I fractures managed with CT exhibited favorable results. Among Class II fractures, those treated with ORIF demonstrated better occlusal alignment and mouth-opening capacity compared to those managed with CT, though no significant difference was observed in maximum mouth opening and masticatory function. In Class III fractures, ORIF resulted in significantly better functional and clinical outcomes compared to CT. Conclusion: Mandibular condyle and subcondylar fractures are more prevalent in males, particularly in the 18 – 39 age group. The outcomes of closed treatment in patients with Class I displaced fractures were favorable, while ORIF demonstrated superior efficacy in Class III fractures. In Class II fractures, no significant difference was observed between CT and ORIF.