This journal club presentation summarizes a study examining the influence of fracture patterns on functional outcomes in patients with bilateral mandibular condylar injuries. The study classified 38 patients into 3 groups based on Chen's classification system: type I (bilateral intracapsular fractures), type II (one intracapsular and one subcondylar fracture), and type III (bilateral subcondylar fractures). The study found that type II injuries had a higher rate (75%) of adverse outcomes like trismus, malocclusion, and need for subsequent surgery compared to 20% for types I and III.

1. Journal Club Presentation
Presented by
Dr. Shweta Yadav
(Junior Resident)
Department of Oral & Maxillofacial Surgery
VSPM Dental College, Nagpur

2. Does Fracture pattern influence functional
outcomes in the Management of bilateral
Mandibular condylar injuries.

4. Introduction
• Retrospective study
• To compare the functional outcomes of different pattern of bilateral
mandibular condylar fractures.
Wang HD, Susarla SM, Yang R, Mundinger GS, Schultz BD, Banda A, MacMillan A, Manson PN, Nam AJ, Dorafshar AH.
Does Fracture Pattern Influence Functional Outcomes in the Management of Bilateral Mandibular Condylar Injuries?.
Craniomaxillofacial trauma & reconstruction. 2019 Sep;12(3):211-20.

6. Primary predictor variable
Fig. 1 Chen’s classification system of bilateral mandibular condylar fractures based on the level
of injury. Type I: bilateral intracapsular condylar fractures (left); type II: one condylar and one
subcondylar fractures (middle); type III: bilateral subcondylar fractures (right).
Wang HD, Susarla SM, Yang R, Mundinger GS, Schultz BD, Banda A, MacMillan A, Manson PN, Nam AJ, Dorafshar AH.
Does Fracture Pattern Influence Functional Outcomes in the Management of Bilateral Mandibular Condylar Injuries?.
Craniomaxillofacial trauma & reconstruction. 2019 Sep;12(3):211-20.

7. Secondary predictor factors
• Demographic
• Cause
• Treatment factors
Wang HD, Susarla SM, Yang R, Mundinger GS, Schultz BD, Banda A, MacMillan A, Manson PN, Nam AJ, Dorafshar AH.
Does Fracture Pattern Influence Functional Outcomes in the Management of Bilateral Mandibular Condylar Injuries?.
Craniomaxillofacial trauma & reconstruction. 2019 Sep;12(3):211-20.

10. Study
• 38 subjects of bilateral condylar fracture
• Primary variable.
• Secondary variable.
Age, Gender
Etiology
Associated fractures
Treatment
Wang HD, Susarla SM, Yang R, Mundinger GS, Schultz BD, Banda A, MacMillan A, Manson PN, Nam AJ, Dorafshar AH.
Does Fracture Pattern Influence Functional Outcomes in the Management of Bilateral Mandibular Condylar Injuries?.
Craniomaxillofacial trauma & reconstruction. 2019 Sep;12(3):211-20.

15. Management decision depends on various factors
• Level of fracture
• Fracture displacement
• Condylar dislocation
• Asso. Injuries of mandible and midface
• State of patient’s dentition
• Adaptability of masticatory system
• Presence of bilateral condylar fracture
Wang HD, Susarla SM, Yang R, Mundinger GS, Schultz BD, Banda A, MacMillan A, Manson PN, Nam AJ, Dorafshar AH.
Does Fracture Pattern Influence Functional Outcomes in the Management of Bilateral Mandibular Condylar Injuries?.
Craniomaxillofacial trauma & reconstruction. 2019 Sep;12(3):211-20.

16. Presence of bilateral condylar fracture
• Open v/s Closed treatment
• Condylar fracture : 20 – 35% of all mandibular fractures
• B/l Condylar fracture : 24 – 33% of all condylar fractures
• Due to impact to anterior mandible
• Other complications.
Wang HD, Susarla SM, Yang R, Mundinger GS, Schultz BD, Banda A, MacMillan A, Manson PN, Nam AJ, Dorafshar AH.
Does Fracture Pattern Influence Functional Outcomes in the Management of Bilateral Mandibular Condylar Injuries?.
Craniomaxillofacial trauma & reconstruction. 2019 Sep;12(3):211-20.

17. Wang HD, Susarla SM, Yang R, Mundinger GS, Schultz BD, Banda A, MacMillan A, Manson PN, Nam AJ, Dorafshar AH.
Does Fracture Pattern Influence Functional Outcomes in the Management of Bilateral Mandibular Condylar Injuries?.
Craniomaxillofacial trauma & reconstruction. 2019 Sep;12(3):211-20.

18. Outcome variables
• Trismus : 3 pts (7.9 %)
• Malocclusion : 6 pts (15.8 %)
• Tmj ankylosis : 2 pts
• Need for a subsequent surgery : 3 pts (TMJ Arthroplasty or
Orthognathic surgery)
Wang HD, Susarla SM, Yang R, Mundinger GS, Schultz BD, Banda A, MacMillan A, Manson PN, Nam AJ, Dorafshar AH.
Does Fracture Pattern Influence Functional Outcomes in the Management of Bilateral Mandibular Condylar Injuries?.
Craniomaxillofacial trauma & reconstruction. 2019 Sep;12(3):211-20.

19. Comparison of Functional outcomes
• Type I injury : 20 %
• Type II injury : Higher rate of adverse outcome (75%)
• Type III injury : 20 %
Wang HD, Susarla SM, Yang R, Mundinger GS, Schultz BD, Banda A, MacMillan A, Manson PN, Nam AJ, Dorafshar AH.
Does Fracture Pattern Influence Functional Outcomes in the Management of Bilateral Mandibular Condylar Injuries?.
Craniomaxillofacial trauma & reconstruction. 2019 Sep;12(3):211-20.

20. Results
Wang HD, Susarla SM, Yang R, Mundinger GS, Schultz BD, Banda A, MacMillan A, Manson PN, Nam AJ, Dorafshar AH.
Does Fracture Pattern Influence Functional Outcomes in the Management of Bilateral Mandibular Condylar Injuries?.
Craniomaxillofacial trauma & reconstruction. 2019 Sep;12(3):211-20.

21. THANK YOU