Comparative Evaluation of Clinical and Radiological Outcomes of Open Reduction & Internal Fixation of Unilateral Subcondylar Fracture With and Without Use of Virtual Surgical Planning and Surgical Template –A Randomised Clinical Study

Mandibular Condylar fractures are relatively common accounting for 29% to 52% of all Mandibular fractures. There are various classification systems describing Mandibular Condylar fractures based on the anatomical position of fracture, degree of displacement and/ or dislocation. There are two principal treatment modalities for these fractures. Traditionally conservative management was most preferred but in recent years Open reduction & Internal fixation (ORIF) has become the method of choice because it can provide better functional and morphological outcomes in terms of mouth opening, occlusal status and facilitates anatomic reduction of Condyle. The challenges most often faced during ORIF include difficulty in controlling the small proximal fragment and achieving good stability. The struggle to achieve good reduction and fixation often prolongs the intraoperative time. Advent of Computed tomography and 3D modelling have enabled better understanding of the level of fracture, degree of comminution, obliquity along the fracture line and hence better treatment planning. Virtual surgical planning has been recently introduced which has enabled surgeons to perform the repositioning of the fragment virtually andpresumably select and precontour the appropriate fixation device thus reducing the intraoperative time and increasing the accuracy of reduction and fixation. This idea has been adopted following its proven efficacy in treatment planning in reconstructive surgeries with Bone grafting and free tissue transfers. A surgical template can made with the help of virtual surgical planning which can aid in holding the proximal fragment in position and help in precise reduction, better control of the proximal fragment and ensure placement of plates in the preplanned position and overall reduce the intraoperative time.The aim of the study is to evaluate whether the use of virtual surgical planning and surgical template can provide an anatomic reduction, require less intraoperative time and ensure enhanced clinical andradiological outcomes