Condylar fractures: is open or closed reduction best?

Abstract

Data sources

Medline was searched and further references were identified from selected papers.

Study selection

Studies were included if they simultaneously compared open and closed techniques with at least one of the following outcome measures: maximum postoperative mouth opening, amount of lateral excursion and protrusion, mandibular deviation on mouth opening, facial symmetry, and joint or muscle pain. They were also required to have had at least 6 months follow-up and have been published in English.

Data extraction and synthesis

Meta-analysis was carried out using the weighted average method for fixed effects and the weighted average method for random effects.

Results

Thirteen studies were included, only one of which was a randomised controlled trial (RCT). Numerous problems were found with the information presented in the various articles. These included lack of patient randomisation, failure to classify the type of condylar fracture, variability within the surgical protocols, and inconsistencies in choice of variables and how they were reported.

Conclusions

Because of the great variation in how the various study parameters were reported, it was not possible to perform a reliable meta-analysis. There is a need for better standardisation of data collection in future studies as well as randomisation of the patients treated so that the two approaches can be accurately compared.

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