Abstract：
The aim of this study is to review the current literature on treatment of subcondylar fractures using traditional open reduction internal fixation (ORIF), closed reduction with maxillomandibular fixation (MMF), and endoscopic open approaches.
PubMed, Embase, Cochrane CENTRAL, Clinicaltrials.gov, and WHO ICTRP.
A comprehensive database search was performed in accordance with PRISMA guidelines. All English-only texts published in the last 20 years with ≥10 patients were included. Studies that included patients <16 years old were excluded.
Thirty-two studies met the final inclusion criteria. Nine studies compared ORIF with closed reduction using MMF, 12 studies evaluated ORIF via different approaches, and 10 studies evaluated outcomes after endoscopic approaches. Five studies reported significant improvement in mouth opening with ORIF compared to closed reduction. In 1 study that recorded patient-reported outcomes measure (FACE-Q scale), quality of life scores and patient satisfaction were significantly higher in the ORIF group. Among the 10 studies that used the endoscopic approach, transient facial nerve injury ranged from 0% to 10%.
Several studies report better mouth opening, dental occlusion, and functional outcomes after ORIF compared to closed reduction, while some found no significant difference. Endoscopic approaches provide ease of access to the condyle with a low incidence of facial nerve injury. However, limitations include special equipment, longer operative times, and a steep learning curve using an endoscope. This review provides surgeons with an overview of the current literature on subcondylar fractures to allow for an individualized management approach for each patient.
PubMed, Embase, Cochrane CENTRAL, Clinicaltrials.gov, and WHO ICTRP.
A comprehensive database search was performed in accordance with PRISMA guidelines. All English-only texts published in the last 20 years with ≥10 patients were included. Studies that included patients <16 years old were excluded.
Thirty-two studies met the final inclusion criteria. Nine studies compared ORIF with closed reduction using MMF, 12 studies evaluated ORIF via different approaches, and 10 studies evaluated outcomes after endoscopic approaches. Five studies reported significant improvement in mouth opening with ORIF compared to closed reduction. In 1 study that recorded patient-reported outcomes measure (FACE-Q scale), quality of life scores and patient satisfaction were significantly higher in the ORIF group. Among the 10 studies that used the endoscopic approach, transient facial nerve injury ranged from 0% to 10%.
Several studies report better mouth opening, dental occlusion, and functional outcomes after ORIF compared to closed reduction, while some found no significant difference. Endoscopic approaches provide ease of access to the condyle with a low incidence of facial nerve injury. However, limitations include special equipment, longer operative times, and a steep learning curve using an endoscope. This review provides surgeons with an overview of the current literature on subcondylar fractures to allow for an individualized management approach for each patient.
摘要：
目的：本研究的目的是回顾使用传统切开复位内固定（ORIF）治疗髁下骨折的现有文献，闭合复位上颌下颌固定术（MMF），和内窥镜开放方法。
方法：PubMed，Embase,科克伦中部,Clinicaltrials.gov,世卫组织ICTRP。
方法：根据PRISMA指南进行全面的数据库搜索。纳入了过去20年发表的所有≥10名患者的纯英语文本。排除包括<16岁患者的研究。
结果：32项研究符合最终纳入标准。九项研究使用MMF将ORIF与闭合还原进行了比较，12项研究通过不同的方法评估了ORIF，10项研究评估了内镜入路后的结局.五项研究报告了与闭合复位相比，ORIF在张口方面的显着改善。在一项记录患者报告结果测量(FACE-Q量表)的研究中，ORIF组患者的生活质量评分和患者满意度显著高于对照组.在使用内窥镜方法的10项研究中，短暂性面神经损伤范围为0%~10%。
结论：一些研究报告了更好的张口，牙齿咬合,与闭合还原相比，ORIF后的功能结果，而有些人没有发现显著差异。内窥镜方法易于进入髁，面神经损伤的发生率低。然而,限制包括特殊设备，更长的手术时间，和使用内窥镜的陡峭学习曲线。这篇综述为外科医生提供了有关con下骨折的最新文献的概述，以允许针对每位患者的个性化管理方法。
方法：PubMed，Embase,科克伦中部,Clinicaltrials.gov,世卫组织ICTRP。
方法：根据PRISMA指南进行全面的数据库搜索。纳入了过去20年发表的所有≥10名患者的纯英语文本。排除包括<16岁患者的研究。
结果：32项研究符合最终纳入标准。九项研究使用MMF将ORIF与闭合还原进行了比较，12项研究通过不同的方法评估了ORIF，10项研究评估了内镜入路后的结局.五项研究报告了与闭合复位相比，ORIF在张口方面的显着改善。在一项记录患者报告结果测量(FACE-Q量表)的研究中，ORIF组患者的生活质量评分和患者满意度显著高于对照组.在使用内窥镜方法的10项研究中，短暂性面神经损伤范围为0%~10%。
结论：一些研究报告了更好的张口，牙齿咬合,与闭合还原相比，ORIF后的功能结果，而有些人没有发现显著差异。内窥镜方法易于进入髁，面神经损伤的发生率低。然而,限制包括特殊设备，更长的手术时间，和使用内窥镜的陡峭学习曲线。这篇综述为外科医生提供了有关con下骨折的最新文献的概述，以允许针对每位患者的个性化管理方法。
