Dr Rahul VC Tiwari - Oral & Maxillofacial Surgery - SIBAR Institute of Dental Sciences, Gunutr,...

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TITLE

• A Detailed Analysis of Mandibular Angle Fractures: Epidemiology,

Patterns, Treatments, and Outcomes

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About the Journal

• Journal Name: JOMS

• Periodicity of journal: MONTHLY

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About the Article

• Date of publication: ---------------

• Type of article: RESEARCH

• Received: 25-02-2016

• Accepted: 05-05-2016

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About the Article contd..

• Author names : NEEL PATEL et al, BEOMJUNE KIN, WALEED

ZAID

• Institutional Attachments : LOUISIANA STATE UHS

• Designations : RESIDENT, OMFS

• Keywords : NOT MENTIONED

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Abstract:

•Informative

•Balanced summary - GIVEN

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Introduction:

• MAFs – Most Common

• Highest Complication Rates – 32%

• Facial lacerations – 32%

• Cervical spine injuries – 2- 10%

• Orthopedic – 12%

• Neurologic injury – 24%

• Thoracic/ abdominal injuries – 12%

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International classifications of diseases(ICD-9)

• 802.20 - closed fracture of mandible, unspecified site

• 802.25 - closed fracture of mandible, angle of jaw

• 802.30 - open fracture of mandible, unspecified site

• 802.35 - open fracture of mandible, angle of jaw

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Objectives:

• The purpose was to analyze mandibular angle fractures (MAFs), looking at

epidemiological trends and mechanisms of injury, and to determine if a

statistically significant relationship existed between certain treatment

modalities and patient outcomes

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Materials and Methods

• Sampling technique: SINGLE OPERATER

• Study design: retrospective chart analysis

• Setting Locations: DATA

• Statistical analysis: SPSS VER 21

• Statistical test: Chi-Squared test, Fisher’s exact test, Wald test,

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TABLE

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Treatment Variables

• methods of fixation

• post-operative intermaxillary fixation (IMF)

• retention versus extraction of teeth in the line of fracture.

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Outcomes

• post-operative infection

• fracture healing

• overall patient comfort.

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STUDY DESIGN

• SAMPLE SIZE: 103

• Mean age - 30.4 years old

• Majority – Males

• Etiology - Physical altercations

• Side - Left side of the face

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Results

• Common concomitant fracture - Contralateral Parasymphysis.

• A statistically significant relationship was noted between methods of fixation and healing, as

well as overall patient comfort, with the Reconstruction plate being associated with the

Champy technique highest rates of bony union and patient Comfort

• No statistically significant correlation was found between methods of fixation and rates of

infection.

• There was no statistically significant link between extraction versus retention of healthy teeth

in the line of fracture or use of IMF with patient comfort, post-operative infection, or fracture

healing.

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16

TABLE

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TABLE


CHARTS


critical appraisal of conclusion

• Despite the fact that the Champy technique and reconstruction plates were associated with

better post-operative outcomes such as patient comfort and fracture healing, these should

not be used interchangeably, operator experience is important and clinical IMF and

extraction versus retention of teeth in the line of fracture did not influence any of the

outcomes.


Suggested Title:

• A retrospective study of 103 patients on epidemiology,

patterns, treatments and outcomes of mandibular angle

fractures done on Louisiana state university.


CRITICAL APPRAISAL OF references

• references in total : 35

• References accessed were : 35

• References are in HARVARD

• Reference before 2006: 17

• Reference after 2006: 18


Champy’s ideal line of osteosynthesis

For angle fractures the ideal line of osteosynthesis is located along the external oblique ridge (A). If it is not possible to plate this area, a miniplate located along the lateral surface of the mandible can also be used (B).

https://www2.aofoundation.org/wps/portal/%21ut/p/a1/04_Sj9CPykssy0xPLMnMz0vMAfGjzOKN_A0M3D2DDbz9_UMMDRyDXQ3dw9wMDAwCTYEKIvEocDQnTr8BDuBoQEi_l35Uek5-EtipkY55ScYW6fpRRalpqUWpRXqlRUDhjJKSgmIrVQNVg_Lycr30_Pz0nFS95Hy9zDxsWjLyi0v0IzBUFuSGRlT5pIYDANTr1h0%21/dl5/d5/L2dJQSEvUUt3QS80SmlFL1o2XzJPMDBHSVMwS09PVDEwQVNFMUdWRjAwME0z/?approach=&bone=CMF&classification=91-Angle%20and%20ramus%2C%20simple&contentUrl=%2Fsrg%2F91%2F05-RedFix%2FORIF%2FAngle_and_ramus%2F91_AN20_2_Principles.enl.jsp&implantstype=One%20miniplate&method=ORIF&redfix_url=1285234126985&segment=Mandible&showPage=redfix&soloState=lb&step=1&subStep=11&treatment=

https://www2.aofoundation.org/wps/portal/Home

https://www2.aofoundation.org/wps/portal/%21ut/p/a1/04_Sj9CPykssy0xPLMnMz0vMAfGjzOKN_A0M3D2DDbz9_UMMDRyDXQ3dw9wMDAwCTYEKIvEocDQnTr8BDuBoQEi_l35Uek5-EtipkY55ScYW6fpRRalpqUWpRXqlRUDhjJKSgmIrVQNVg_Lycr30_Pz0nFS95Hy9zDxsWjLyi0v0IzBUFuSGRlT5pIYDANTr1h0%21/dl5/d5/L2dJQSEvUUt3QS80SmlFL1o2XzJPMDBHSVMwS09PVDEwQVNFMUdWRjAwMFE1/

Dr Rahul VC Tiwari - Oral & Maxillofacial Surgery - SIBAR Institute of Dental Sciences, Gunutr,...

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