Aetiology and pattern of 122 patients with mandibular condylar fracture

Aetiology and pattern of 122 patients with mandibular condylar fracture | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Aetiology and pattern of 122 patients with mandibular condylar fracture Maryam Paknahad, Hossein Daneste, Reza Daryani, Azita Sadeghzade This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7814440/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective This research sought to examine the aetiology and pattern of Mandibular Condylar Fractures (MCF). Methods Data on patients who had MCF from 2018 to 2020 were documented, including fracture aetiology, site, kind, fracture line angle, and concomitant injuries. The data were further analysed with the chi-square test, t-test, and ANOVA. Results This research included 122 patients (94 men and 28 females), yielding a male-to-female ratio of 3.35:1 and an average age of 30.7 years. Road traffic accidents was the predominant cause of fractures, accounting for 75.4%. Of the 153 fractures, 75 (49.01%) were categorised as subcondylar fractures, 69 (45.09%) as condylar neck fractures, and 9 (5.9%) as condylar head fractures. Among several forms of MCF, MacLennan class III was the most frequent (n = 56, 36.6%), whereas MacLennan class I was the least common type of fracture (n = 13, 8.5%). Moreover, symphysis and maxillary fractures were more prevalent in individuals with bilateral condylar fractures compared to those with unilateral condylar fractures (p = 0.017 and p = 0.035, respectively). On the other hand, individuals who had unilateral condylar fractures were more likely to have mandibular body fractures than those who had bilateral condylar fractures (p = 0.015). In cases where the condylar neck and sub-condylar fractures were present, the average angle of the fracture line with the posterior border of the ramus was 120.85 11.14 degrees. Conclusion A motor traffic collision was the predominant aetiology of MCF. The findings indicated a substantial correlation between the severity of condylar fractures and the concomitant injuries. Clinical Trial Number: IR.SUMS.DENTAL.REC.1399.120 Mandibular fracture Mandibular angle Unilateral Bilateral Trauma Figures Figure 1 Figure 2 Figure 3 Introduction Mandibular fractures are among the most prevalent injuries in individuals with craniofacial trauma ( 1 ). The prevalence of MCF has been reported as 29–52% of all mandibular fractures ( 2 – 6 ). A multitude of investigations has been conducted on the aetiology of condylar fractures. Silvennoinen et al ( 6 ) mentioned violence as the most common cause of these fractures. In other studies, falls were found to be the leading cause of condylar fractures in women and children ( 7 , 8 ). Recent studies, however, have shown that Road Traffic Accidents (RTA) played a significant role in these fractures ( 4 , 5 , 9 , 10 ). According to the anatomical level of fractures, there are three types of condylar fractures: the condylar head (intracapsular), the condylar neck, and the sub-condylar area ( 6 , 11 – 13 ). Fracture displacement depends on the direction, degree, magnitude, and point of force application. Dentition and occlusion statuses are essential, as well ( 10 ). The fracture may be categorised as undisplaced, deviated, displaced (with medial or lateral overlap or total separation), and dislocated (external to the glenoid fossa) ( 14 ). Understanding the pattern of maxillofacial trauma can help determine preventive policies and evaluate treatment modalities ( 5 ). The current research is to ascertain the epidemiological features and incidence of mandibular condylar fractures within a specific group. More and more in-depth articles related to the proposed topic are given below for further reading: The ( 15 ) discusses the etiology, classification, clinical features, diagnosis, and management of mandibular condyle fractures. It highlights that these fractures account for 10–40% of mandibular trauma, with a higher incidence in children. Falls, incidents involving vehicles on the road, and injuries sustained in sports are all common causes. The chapter also covers treatment protocols for different age groups and the indications for closed versus open reduction. The study ( 16 ) analyzes the etiology of mandibular condylar fractures in a tertiary care setting. It found that falls (45.71%) and road traffic accidents (40%) were the predominant causes. The study also noted a higher incidence of fractures in males, particularly in the third decade of life. Detailed radiological investigations were emphasized for accurate diagnosis. The article ( 17 ) examines the frequency and patterns of mandibular condyle fractures, noting that motor vehicle accidents (44.20%) and cycling (24.61%) are the leading causes. The study also discusses the anatomical vulnerability of the condylar region and the importance of early and accurate diagnosis to prevent complications. The research ( 18 ) focuses on the clinical presentation and etiology of mandibular condylar fractures. It identifies road traffic accidents and falls as the primary causes, with many cases involving young adults. The study underscores the need for comprehensive clinical and radiographic evaluation to guide effective treatment strategies. The retrospective analysis reviews the patterns and causes of mandibular condylar fractures over a specified period ( 19 ). It highlights that interpersonal violence and sports injuries are also notable causes, alongside falls and traffic accidents. The study emphasizes the role of multidisciplinary approaches in managing these fractures to ensure optimal patient outcomes. The reference ( 20 ) provides a comprehensive overview of mandibular and midface fractures, including the etiology, clinical features, and diagnostic methods. It emphasizes the importance of dental X-rays and CT scans for accurate diagnosis. The study highlights that mandibular condyle fractures often result from blunt trauma, with symptoms including preauricular pain and limited mouth opening. It is possible to treat a fracture in a variety of ways, ranging from conservative therapy to surgical intervention, depending on the degree of the fracture and its displacement. The article ( 21 ) discusses the common causes and treatment options for condylar fractures. According to what is said in the article, the majority of condylar fractures are brought on by blunt trauma to the anterior mandible, which subsequently causes forces to be transferred to the condylar region. This study examines the anatomical variables that contribute to the restriction of posterior mobility of the jaw, as well as the role that the glenoid fossa, the TMJ capsule, and the lateral pterygoid muscles play in this regard. The treatment methods include both closed and open reduction, with the primary goal of reducing the presence of problems. The ( 22 ) covers the etiology, clinical presentation, and management of mandibular condyle fractures. It highlights the controversies in treatment approaches, particularly the decision between open and closed reduction. The chapter emphasizes the importance of understanding the complex anatomy of the temporomandibular joint and the need for thorough clinical and radiographic evaluation. It also discusses the potential complications and the role of physiotherapy in recovery. Material/Subjects/Patients and methods The Institutional Research Ethics Committee sanctioned the current research. The medical records of the patients with facial trauma admitted to a trauma centre between January 2018 and December 2020 were reviewed. An investigator collected and standardised the information and data that was acquired from the patient's medical records, clinical and radiographic exams, and the patient's medical history. In order to be considered for participation in the research, participants needed to have either unilateral or bilateral condylar fractures that were caused by trauma. The exclusion criteria included incomplete information regarding the trauma in the medical records and a history of prior condylar fractures. The data relating to the aetiology, location, and type of the fracture, as well as the fracture line angle and the associated injuries, were collected. The patients were etiologically divided into three groups, i.e., RTA, falling, and violence (assault). The fractures were classified using Computed Tomography (CT) examinations. According to Loukota et al ( 23 ), the fractures were classified into three categories: sub-condylar, condylar head, and condylar neck fractures by taking into consideration the position of the fractures (Fig. 1 ). Moreover, based on MacLennan’s research ( 14 ), fracture types were categorized into four subclasses according to the degree of displacement: Non-displaced Deviated The condylar head was still located inside the glenoid fossa, despite the fact that the proximal and distal fracture portions overlapped one another. The condylar head was dislocated, meaning that it was situated outside of the glenoid fossa (Fig. 2 ). In addition, the injuries that were associated with the incident were classified as fractures of the mandibular bone (including the symphysis, body, angle, ramus, and coronoid), maxillary bone, zygomatic bone, and nasal bone. The angle of the fracture line was evaluated in the sagittal view for cases with condylar neck and sub-condylar fractures (Fig. 3 ). This evaluation was performed between the fracture line and the posterior border of the ramus where the fracture line was located. SPSS Statistics for Windows, version 23 (written by SPSS et al. in the United States), was used for each and every statistical analysis. The results of the descriptive analysis of the data were described using either the mean (standard deviation) or the frequency (percentage). In order to analyse the categorical variables, a chi-square test was carried out. These variables comprised age groups, gender, aetiology, fracture line location, fracture type, and associated injuries. The objective of this test was to ascertain the degree of correlation that existed between the variables that were classified into the categories. To determine whether or not there was a link between the age of the fractures and the cause of the fractures in both males and females individually, we used a t-test. This allowed us to determine whether or not there was a correlation. We employed a statistical method known as analysis of variance (ANOVA) to study the link that exists between the average angle of the fracture line and the underlying cause of the fracture. This was done in order to determine whether or not there is a connection between the two. In order to determine whether or not the findings were statistically significant, it was essential that the P-value be lower than 0.05. Results This investigation involved a cohort of 122 individuals, comprising 94 males and 28 females, resulting in a male-to-female ratio of 3.35:1. The average age of the patients was 30.70 ± 11.39 years, with a range spanning from 12 to 65 years. The distribution of sexes across various age cohorts has been encapsulated in Table 1 . The results of the chi-square test indicated an absence of a statistically significant correlation between age and sex distribution, with the majority of patients falling within the 21–30 age bracket (39.3%). Table 1 Gender distribution across various age demographics Age (years) Male Female Total P-value Male:female ratio 12–20 19 (20.2%) 4 (14.3%) 23 (18.9%) 0.482 4.75:1 21–30 35 (37.2%) 13 (46.4%) 48 (39.3%) 0.382 2.69:1 31–40 22 (23.4%) 5 (17.9%) 27 (22.1%) 0.535 4.40:1 41–50 12 (12.8%) 4 (14.3%) 16 (13.1%) 0.834 3.00:1 > 50 6 (6.4%) 2 (7.1%) 8 (6.6%) 0.887 3.00:1 Of the 122 patients diagnosed with MCF, 91 individuals, representing 74.6%, exhibited unilateral fractures, while 31 individuals, accounting for 25.4%, presented with bilateral fractures. Among the 153 condylar fractures, 79 occurred on the left condyle while 74 were observed on the right condyle. The predominant cause of MCF was RTA (n = 92), succeeded by falls (n = 22) and physical assault (n = 8). When it came to the causes of fractures, the chi-square test revealed that there was no statistically significant difference between the two sexes. This was the conclusion reached by the researchers. Furthermore, the t-test findings revealed no notable correlation between the aetiology of fractures and age across both genders (Table 2 ). Table 2 Sex and age distribution according to different etiologies Etiology Sex distribution (n = 122) Age Male Female P-value Male (mean ± SD) Female (mean ± SD) P-value Road traffic accident 70 (74.5%) 22 (78.6%) 0.658 31.46 ± 11.56 30.77 ± 11.59 0.809 Falling down 16 (17.0%) 6 (21.4%) 0.594 28.69 ± 11.38 28.68 ± 15.83 0.997 Assault 8 (8.5%) 0 (0.0%) 0.110 29.50 ± 6.74 - - Among the various classifications of MCF, MacLennan class III emerged as the most prevalent, with a total of 56 instances, accounting for 36.6% of the cases. In contrast, MacLennan class I represented the least common type, with only 13 occurrences, which corresponds to 8.5%. The findings of the chi-square test suggested that there was no statistically significant correlation between the aetiology and the kind of fractures (p = 0.706) (Table 3 ). This was the conclusion reached by the researchers. Table 3 Type and location of the fractures according to different etiologies Etiology MacLennan class of fractures (n = 153) Location of fractures (n = 153) I II III IV P-value Condylar head Condylar neck Subcondylar P-value RTA 12 (7.8%) 31 (20.3%) 41 (26.8%) 36 (23.5%) 0.706 8 (5.2%) 51 (33.3%) 61 (39.9%) 0.292 Falling down 1 (0.7%) 7 (4.6%) 10 (6.5%) 7 (4.6%) 1 (0.7%) 12 (7.8%) 12 (7.8%) Assault 0 (0%) 0 (0%) 5 (3.3%) 3 (1.9%) 0 (0%) 6 (4.0%) 2 (1.3%) In light of the geographical context, the majority of fractures (n = 75, 0%) were identified as subcondylar, succeeded by condylar neck fractures (n = 69, 0%) and condylar head fractures (n = 9, 0%). Table 3 displays the findings of the chi-square test, which indicated that there was no statistically significant correlation between the site of fractures and the aetiology of those fractures (p = 0.292). Table 4 indicates that 91 fractures, accounting for 74.6%, were unilateral, while 31 fractures, representing 25.4%, were bilateral. The results of the chi-square test indicated a noteworthy correlation between the aetiology of fractures and the severity of injuries, specifically in the context of unilateral and bilateral condylar fractures (p = 0.071). Table 4 Fracture severity based on the injury's aetiology Etiology Severity of injury (n = 122) UF (n = 91) BF (n = 31) P-value RTA 64 (70.3%) 28 (90.3%) 0.071 Falling down 19 (20.9%) 3 (9.7%) Assault 8 (8.8%) 0 (0%) UF, unilateral fracture; BF, bilateral fracture; RTA, road traffic accident. The incidence of patients who experienced concomitant injuries alongside unilateral and bilateral condylar fractures has been enumerated and juxtaposed in Table 5 . Consequently, the incidence of symphysis and maxillary fractures was notably higher in patients exhibiting bilateral condylar fractures compared to those with unilateral fractures (p = 0.017 and p = 0.035, respectively). In contrast, the incidence of mandibular body fractures was significantly greater in cases of unilateral fractures compared to those with bilateral condylar fractures (p = 0.015). This was true for both unilateral and bilateral fractures. When it came to the mandibular angle, there was a significant difference between individuals who had unilateral fractures and those who had bilateral fractures (p = 0.064). Table 5 The incidence of individuals with concomitant injuries related to unilateral and bilateral condylar fractures Associated injuries Number of patients with UF (n = 91) Number of patients with BF (n = 31) Total (n = 122) P-value Mandibular fractures Symphysis 39 (42.8%) 21 (67.7%) 60 (49.1%) 0.017 Body 25 (27.4%) 2 (6.4%) 27 (22.1%) 0.015 Angle 11 (12.0%) 0 (0%) 11 (9.0%) 0.064 Ramus 5 (5.4%) 2 (6.4%) 7 (5.7%) 1.000 Coronoid 3 (3.2%) 1 (3.2%) 4 (3.2%) 1.000 Maxillary fractures 18 (19.7%) 12 (38.7%) 30 (24.5%) 0.035 Zygomatic fractures 16 (17.5%) 6 (19.3%) 22 (18.0%) 0.825 Nasal fractures 14 (15.3%) 7 (22.5%) 21 (17.2%) 0.359 UF, unilateral fracture; BF, bilateral fracture. When it comes to cases involving condylar neck and sub-condylar fractures, the average angle of the fracture line in regard to the posterior border of the ramus was measured to be 120.85 11.14 degrees. According to the findings of the analysis of variance, there was not a statistically significant connection between the aetiology of the fracture and the mean fracture line angle (p = 0.711) (Table 6 ). This was the conclusion reached by scientists. Table 6 The average angle of the fracture line with the posterior border of the ramus in instances of condylar neck and sub-condylar fractures based on the injury's source. Etiology Angle (Mean ± SD) P-value Road traffic accident 120.83 ± 11.79 0.711 Falling down 121.98 ± 8.26 Assault 118.13 ± 11.20 Discussion Epidemiological studies of condylar fractures can effectively understand the pattern of these fractures and implement preventive policies ( 5 ). The present study on MCF indicated the most involved age groups, prevalence of different etiologies, locations, types of fracture, frequency of the patients sustaining the associated injuries, and the mean of fracture line angle. In the present study, the male/female ratio was 3.35:1, which was similar to that found in other studies ( 2 , 3 , 5 , 6 , 9 , 10 ), but greater than the ratio reported by Marker et al (2:1) ( 4 ). Additionally, the mean age of the patients was 30.7 years, which was in agreement with the studies carried out by Silvennoinen et al ( 6 ), Marker et al ( 4 ), and Sawazaki et al ( 5 ). Furthermore, the 21–30 age group was more prone to condylar fractures, which was in line with the findings of other reports ( 5 , 24 ). The current study findings revealed no significant relationship between age group and sex ratio. However, Zhou et al showed a decrease in the male/female ratio in the 11–20 age group compared to other age groups. This may be because women in the 11–20 age group play active societal roles. Besides, around the age of puberty, they suffer from MCF almost as much as men do. Nonetheless, the male/female ratio markedly increased in the patients aged 21–30. This may be attributed to the change in the roles played by men and women in the 21–30 age group. In this age group, men are more active in the workplace, while women are more preoccupied with childbirth and childcare ( 24 ). Previous studies have demonstrated different etiologies of MCF in various countries. Violence has been identified as the most common aetiology in Scotland ( 3 ) and Finland ( 6 ). In addition, falls are the most common cause in Sri Lanka ( 2 ). However, recent studies have indicated that RTA has been the most common cause of condylar fractures in developed and developing countries ( 4 , 5 , 9 , 10 , 24 ). RTA was also the leading cause of trauma in the current investigation. The disparity in outcomes observed in the current study and those of other studies can be attributed to population mobility, careless driving, unsafe roads, improper road traffic policies, unsafe cars, discrepancies in geographical areas, people's socioeconomic status, and date of injury. Loukota et al ( 23 ) a straightforward and accurate method for classifying condylar fractures was proposed. In this classification, condylar fractures have been divided into three categories, namely condylar head, condylar neck, and subcondylar fractures. In the current research, the most frequent fractures were subcondylar (49%), followed by condylar neck (45%) and condylar head (6%) fractures. Similar results were also obtained by Zachariades et al ( 10 ), Sawazaki et al ( 5 ), and Reddy et al ( 25 ). However, condylar head fractures are most common in a few studies ( 24 , 26 ). Moreover, several studies demonstrated that the location of condylar fractures was directly affected by the cause of the injury ( 9 , 10 ). According to Marker et al ( 4 ), condylar head fractures occurred more frequently in cases where considerable force was involved. In other words, sub-condylar fractures were more likely to occur when the damage was caused by a weak force (alleged assault). The present study results revealed no significant relationship between the aetiology and location of the fractures. However, there were no patients under 12 in this study. Children are more prone to condylar head fractures ( 27 ). MacLennan ( 14 ) classified the types of fractures into four groups. In the current study, MacLennan's class III was the predominant type of MCF (36.6%), consistent with other studies' results ( 9 , 10 ). On the contrary, Zhou et al ( 24 ) disclosed that class IV was the most common type of MCF. Research indicates that severe fractures (MacLennan's class IV) are more prevalent in instances resulting from high-velocity accidents, such as falls and road traffic accidents (RTA). In contrast, MacLennan's class I and II condylar fractures typically resulted from assaults characterised by lower force intensities ( 24 , 26 ). The current investigation did not find any evidence of a substantial connection between the aetiology and the kind of fractures it examined. The study findings demonstrated that bilateral fractures occurred slightly more frequently when a considerable force was applied (RTA). In contrast, unilateral fractures occurred when a weak force was applied (alleged assault). Similar results were obtained by Marker et al ( 4 ). In the present study, individuals with concomitant mandibular fractures with condylar fractures comprised 68% of the sample. The most commonly associated mandibular fracture with condylar fracture was symphysis fractures, followed by mandibular body fractures. These findings were consistent with those of the previous studies conducted on the issue ( 5 , 6 , 10 , 12 ). In the present study, symphysis fractures were found more frequently in the cases with bilateral condylar fractures, which was in line with the findings of the study by Zhou et al. ( 24 ). Nevertheless, body fractures occurred more often in instances with unilateral condylar fractures compared to those with bilateral condylar fractures. The fracture angle was marginally elevated in instances of unilateral condylar fractures. Zhou et al ( 24 ) did not find any significant relationships between mandibular body fractures and the severity of condylar fractures (unilateral or bilateral condyle fractures). Nonetheless, they observed a significant relationship between mandibular angle fractures and the fracture severity (unilateral or bilateral condyle fracture). Generally, the mandibular body and angle fractures absorb a part of the applied force, causing unilateral fractures. However, the force exerted on the mandibular body and angle can be transmitted along the mandibular arch, leading to contralateral condyle fracture. In the research by Zhou et al ( 24 ), no significant relationship was observed between maxillary fracture and fracture severity (unilateral or bilateral condyle fracture). However, this relationship was significant in the current study. Accordingly, maxillary fracture was more frequent in the patients with bilateral condylar fractures. In individuals with bilateral condylar fractures, significant strain is exerted on the head and face, leading to maxillary fracture. Conclusion The findings of the current investigation indicated that road traffic accidents were the predominant cause of mandibular condylar fractures. The findings indicated no substantial correlation between the different sources of condylar fractures and gender, age, as well as the location and type of fractures. The subcondylar region was the predominant site for condylar fractures, with MacLennan class III being the most prevalent form. Furthermore, symphysis and maxillary fractures were more prevalent in individuals with bilateral condylar fractures compared to those with unilateral condylar fractures. In contrast, mandibular body fractures occurred more often in instances with unilateral fractures compared to those with bilateral condylar fractures. Declarations Conflict of interest: Funding : Author Contribution Conceptualization: Azita Sadeghzade.Study design & methodology: Azita Sadeghzade; Maryam Paknahad; Hossein Daneste.Ethics approval & project administration: Azita Sadeghzade.Resources & patient management: Hossein Daneste.Data curation (chart extraction, registry abstraction): Reza Daryani; Maryam Paknahad.Imaging acquisition/interpretation (CT classification; angle measurements): Maryam Paknahad.Validation (case verification; classification cross-check): Hossein Daneste; Maryam Paknahad.Formal analysis & statistics (chi-square, t-test, ANOVA): Maryam Paknahad; Azita Sadeghzade.Visualization (tables/figures): Maryam Paknahad.Writing – original draft: Maryam Paknahad; Reza Daryani.Writing – review & editing (critical revision for intellectual content): Azita Sadeghzade; Hossein Daneste; Maryam Paknahad.Supervision: Azita Sadeghzade.Guarantor: Azita Sadeghzade accepts full responsibility for the integrity of the work as a whole.All authors read and approved the final manuscript and agree to be accountable for all aspects of the work.Corresponding author: Azita Sadeghzade, Oral and Dental Disease Research Center, Department of Oral and Maxillofacial Medicine, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran. Telefax: +98-71-36263193; E-mail: [email protected] Acknowledgement: The authors would like to thank Ms. A. Keivanshekouh at the Research Consultation Center (RCC) of Shiraz University of Medical Sciences for improving the use of English in the manuscript. References Iida S, Kogo M, Sugiura T, Mima T, Matsuya T. Retrospective analysis of 1502 patients with facial fractures. International journal of oral and maxillofacial surgery. 2001;30(4):286-90. Amaratunga NdS. A study of condylar fractures in Sri Lankan patients with special reference to the recent views on treatment, healing and sequelae. British Journal of Oral and Maxillofacial Surgery. 1987;25(5):391-7. Ellis E, Moos KF, El-Attar A. Ten years of mandibular fractures: an analysis of 2,137 cases. Oral surgery, oral medicine, oral pathology. 1985;59(2):120-9. Marker P, Nielsen A, Bastian HL. Fractures of the mandibular condyle. Part 1: patterns of distribution of types and causes of fractures in 348 patients. 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Intracapsular condylar fracture of the mandible: our classification and open treatment experience. Journal of oral and maxillofacial surgery. 2009;67(8):1672-9. Zhou H-H, Lv K, Yang R-T, Li Z, Yang X-W, Li Z-B. Mandibular condylar fractures in children and adolescents: 5-Year retrospective cohort study. International journal of pediatric otorhinolaryngology. 2019;119:113-7. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7814440","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":542074159,"identity":"68a845d7-0941-4fad-9954-6638bd04068f","order_by":0,"name":"Maryam Paknahad","email":"","orcid":"","institution":"Shiraz University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Maryam","middleName":"","lastName":"Paknahad","suffix":""},{"id":542074160,"identity":"0751fb13-a7d4-4cc2-b166-2bbf06e01a58","order_by":1,"name":"Hossein Daneste","email":"","orcid":"","institution":"Shiraz University of Medical 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Sadeghzade","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA/ElEQVRIiWNgGAWjYLACHgaGBCBlwPABLmRApBbGGSRrYeYhxk38DewPP7ypqM2Tbz+88bHNn8PR8g3MDz8wFNzDqUXiAI+x5Jwzx4sZe9KKjXPbDuduOMBmLMFgUIzbmgM8DNK8bccSmxlyzKRzG4BaGBjMgI5MwKlD/gD749+8/44ltvG/Mf9t8edw7vwG9m94tRgcYDCT5m2oSeyRyDFjZmA7nNtwgAe/LYZABZZzjh1InCHxrFiyty09d8NhnmKJBDxa5IAOu/Gmpi5xfn/yxg8//ljnzm9v3/jhwx/cWhjkH4DIw0gizAyQaCIA6ggrGQWjYBSMgpELAExWVNZM6VjCAAAAAElFTkSuQmCC","orcid":"","institution":"Shiraz University of Medical Sciences","correspondingAuthor":true,"prefix":"","firstName":"Azita","middleName":"","lastName":"Sadeghzade","suffix":""}],"badges":[],"createdAt":"2025-10-09 07:39:22","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7814440/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7814440/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":96073425,"identity":"101f1b26-a5af-4fac-bc75-6c2b31c23e7b","added_by":"auto","created_at":"2025-11-17 10:17:38","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":828253,"visible":true,"origin":"","legend":"","description":"","filename":"Aetiologyandpattern.docx","url":"https://assets-eu.researchsquare.com/files/rs-7814440/v1/4649460399d6e885ef8ae8ff.docx"},{"id":96073420,"identity":"e2c14855-a898-4f25-b3bc-06902a1f5fb9","added_by":"auto","created_at":"2025-11-17 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10:17:38","extension":"xml","order_by":9,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":90710,"visible":true,"origin":"","legend":"","description":"","filename":"ab6b692996fc491099a69b793bd5524f1structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-7814440/v1/6645687bcabed4c2a567cbdf.xml"},{"id":96073430,"identity":"a9501899-3401-454b-9194-721357776fca","added_by":"auto","created_at":"2025-11-17 10:17:38","extension":"html","order_by":10,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":104215,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7814440/v1/45643c31d66114984820a810.html"},{"id":96073419,"identity":"28c63c3a-f49a-4431-97de-85afac161373","added_by":"auto","created_at":"2025-11-17 10:17:38","extension":"jpeg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":271510,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eA: Condylar head fracture: articular surface fracture line may extend outside capsule. B: Condylar neck fracture: the fracture line begins above line x and goes above it in over half. Line x runs perpendicularly from the sigmoid notch to the ramus tangent. C: Sub-condylar fracture: below the mandibular foramen and below line x in over half.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7814440/v1/0bcc35f6864564a7122a5f78.jpeg"},{"id":96073418,"identity":"6bbd96cd-df3b-40ff-bb92-cc590dfc7b05","added_by":"auto","created_at":"2025-11-17 10:17:38","extension":"jpeg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":324910,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eA: Non-displaced, B: deviated, C: displaced, D: dislocated.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage2.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7814440/v1/75e6c866e17c2c973c0b0689.jpeg"},{"id":96073424,"identity":"6ee78c02-eba6-43ed-aa8c-5959bb2ce82d","added_by":"auto","created_at":"2025-11-17 10:17:38","extension":"jpeg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":163506,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eThe fracture line angle\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage3.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7814440/v1/20f932e192611e419838d212.jpeg"},{"id":96256358,"identity":"e0abea52-862c-4c27-a249-c08daf0b8dff","added_by":"auto","created_at":"2025-11-19 07:50:03","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1806035,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7814440/v1/61094c61-835e-4457-aa8a-e1bdd6c70349.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Aetiology and pattern of 122 patients with mandibular condylar fracture","fulltext":[{"header":"Introduction","content":"\u003cp\u003eMandibular fractures are among the most prevalent injuries in individuals with craniofacial trauma (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). The prevalence of MCF has been reported as 29\u0026ndash;52% of all mandibular fractures (\u003cspan additionalcitationids=\"CR3 CR4 CR5\" citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eA multitude of investigations has been conducted on the aetiology of condylar fractures. Silvennoinen et al (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e) mentioned violence as the most common cause of these fractures. In other studies, falls were found to be the leading cause of condylar fractures in women and children (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Recent studies, however, have shown that Road Traffic Accidents (RTA) played a significant role in these fractures (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAccording to the anatomical level of fractures, there are three types of condylar fractures: the condylar head (intracapsular), the condylar neck, and the sub-condylar area (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan additionalcitationids=\"CR12\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). Fracture displacement depends on the direction, degree, magnitude, and point of force application. Dentition and occlusion statuses are essential, as well (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). The fracture may be categorised as undisplaced, deviated, displaced (with medial or lateral overlap or total separation), and dislocated (external to the glenoid fossa) (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eUnderstanding the pattern of maxillofacial trauma can help determine preventive policies and evaluate treatment modalities (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). The current research is to ascertain the epidemiological features and incidence of mandibular condylar fractures within a specific group. More and more in-depth articles related to the proposed topic are given below for further reading:\u003c/p\u003e\u003cp\u003eThe (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e) discusses the etiology, classification, clinical features, diagnosis, and management of mandibular condyle fractures. It highlights that these fractures account for 10\u0026ndash;40% of mandibular trauma, with a higher incidence in children. Falls, incidents involving vehicles on the road, and injuries sustained in sports are all common causes. The chapter also covers treatment protocols for different age groups and the indications for closed versus open reduction.\u003c/p\u003e\u003cp\u003eThe study (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e) analyzes the etiology of mandibular condylar fractures in a tertiary care setting. It found that falls (45.71%) and road traffic accidents (40%) were the predominant causes. The study also noted a higher incidence of fractures in males, particularly in the third decade of life. Detailed radiological investigations were emphasized for accurate diagnosis.\u003c/p\u003e\u003cp\u003eThe article (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e) examines the frequency and patterns of mandibular condyle fractures, noting that motor vehicle accidents (44.20%) and cycling (24.61%) are the leading causes. The study also discusses the anatomical vulnerability of the condylar region and the importance of early and accurate diagnosis to prevent complications.\u003c/p\u003e\u003cp\u003eThe research (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e) focuses on the clinical presentation and etiology of mandibular condylar fractures. It identifies road traffic accidents and falls as the primary causes, with many cases involving young adults. The study underscores the need for comprehensive clinical and radiographic evaluation to guide effective treatment strategies.\u003c/p\u003e\u003cp\u003eThe retrospective analysis reviews the patterns and causes of mandibular condylar fractures over a specified period (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). It highlights that interpersonal violence and sports injuries are also notable causes, alongside falls and traffic accidents. The study emphasizes the role of multidisciplinary approaches in managing these fractures to ensure optimal patient outcomes.\u003c/p\u003e\u003cp\u003eThe reference (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e) provides a comprehensive overview of mandibular and midface fractures, including the etiology, clinical features, and diagnostic methods. It emphasizes the importance of dental X-rays and CT scans for accurate diagnosis. The study highlights that mandibular condyle fractures often result from blunt trauma, with symptoms including preauricular pain and limited mouth opening. It is possible to treat a fracture in a variety of ways, ranging from conservative therapy to surgical intervention, depending on the degree of the fracture and its displacement.\u003c/p\u003e\u003cp\u003eThe article (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e) discusses the common causes and treatment options for condylar fractures. According to what is said in the article, the majority of condylar fractures are brought on by blunt trauma to the anterior mandible, which subsequently causes forces to be transferred to the condylar region. This study examines the anatomical variables that contribute to the restriction of posterior mobility of the jaw, as well as the role that the glenoid fossa, the TMJ capsule, and the lateral pterygoid muscles play in this regard. The treatment methods include both closed and open reduction, with the primary goal of reducing the presence of problems.\u003c/p\u003e\u003cp\u003eThe (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e) covers the etiology, clinical presentation, and management of mandibular condyle fractures. It highlights the controversies in treatment approaches, particularly the decision between open and closed reduction. The chapter emphasizes the importance of understanding the complex anatomy of the temporomandibular joint and the need for thorough clinical and radiographic evaluation. It also discusses the potential complications and the role of physiotherapy in recovery.\u003c/p\u003e"},{"header":"Material/Subjects/Patients and methods","content":"\u003cp\u003e The Institutional Research Ethics Committee sanctioned the current research. The medical records of the patients with facial trauma admitted to a trauma centre between January 2018 and December 2020 were reviewed. An investigator collected and standardised the information and data that was acquired from the patient's medical records, clinical and radiographic exams, and the patient's medical history. In order to be considered for participation in the research, participants needed to have either unilateral or bilateral condylar fractures that were caused by trauma. The exclusion criteria included incomplete information regarding the trauma in the medical records and a history of prior condylar fractures.\u003c/p\u003e\u003cp\u003eThe data relating to the aetiology, location, and type of the fracture, as well as the fracture line angle and the associated injuries, were collected. The patients were etiologically divided into three groups, i.e., RTA, falling, and violence (assault). The fractures were classified using Computed Tomography (CT) examinations. According to Loukota et al (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e), the fractures were classified into three categories: sub-condylar, condylar head, and condylar neck fractures by taking into consideration the position of the fractures (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eMoreover, based on MacLennan\u0026rsquo;s research (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e), fracture types were categorized into four subclasses according to the degree of displacement:\u003c/p\u003e\u003cp\u003e\u003col\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eNon-displaced\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eDeviated\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eThe condylar head was still located inside the glenoid fossa, despite the fact that the proximal and distal fracture portions overlapped one another.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eThe condylar head was dislocated, meaning that it was situated outside of the glenoid fossa (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003c/ol\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eIn addition, the injuries that were associated with the incident were classified as fractures of the mandibular bone (including the symphysis, body, angle, ramus, and coronoid), maxillary bone, zygomatic bone, and nasal bone. The angle of the fracture line was evaluated in the sagittal view for cases with condylar neck and sub-condylar fractures (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eThis evaluation was performed between the fracture line and the posterior border of the ramus where the fracture line was located. SPSS Statistics for Windows, version 23 (written by SPSS et al. in the United States), was used for each and every statistical analysis. The results of the descriptive analysis of the data were described using either the mean (standard deviation) or the frequency (percentage). In order to analyse the categorical variables, a chi-square test was carried out. These variables comprised age groups, gender, aetiology, fracture line location, fracture type, and associated injuries.\u003c/p\u003e\u003cp\u003eThe objective of this test was to ascertain the degree of correlation that existed between the variables that were classified into the categories. To determine whether or not there was a link between the age of the fractures and the cause of the fractures in both males and females individually, we used a t-test. This allowed us to determine whether or not there was a correlation. We employed a statistical method known as analysis of variance (ANOVA) to study the link that exists between the average angle of the fracture line and the underlying cause of the fracture. This was done in order to determine whether or not there is a connection between the two. In order to determine whether or not the findings were statistically significant, it was essential that the P-value be lower than 0.05.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThis investigation involved a cohort of 122 individuals, comprising 94 males and 28 females, resulting in a male-to-female ratio of 3.35:1. The average age of the patients was 30.70\u0026thinsp;\u0026plusmn;\u0026thinsp;11.39 years, with a range spanning from 12 to 65 years. The distribution of sexes across various age cohorts has been encapsulated in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. The results of the chi-square test indicated an absence of a statistically significant correlation between age and sex distribution, with the majority of patients falling within the 21\u0026ndash;30 age bracket (39.3%).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eGender distribution across various age demographics\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge (years)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eP-value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eMale:female ratio\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003e12\u0026ndash;20\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e19 (20.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4 (14.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e23 (18.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.482\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e4.75:1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003e21\u0026ndash;30\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e35 (37.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e13 (46.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e48 (39.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.382\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e2.69:1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003e31\u0026ndash;40\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e22 (23.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e5 (17.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e27 (22.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.535\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e4.40:1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003e41\u0026ndash;50\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e12 (12.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4 (14.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e16 (13.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.834\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e3.00:1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003e\u0026gt;\u0026thinsp;50\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e6 (6.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2 (7.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e8 (6.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.887\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e3.00:1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eOf the 122 patients diagnosed with MCF, 91 individuals, representing 74.6%, exhibited unilateral fractures, while 31 individuals, accounting for 25.4%, presented with bilateral fractures. Among the 153 condylar fractures, 79 occurred on the left condyle while 74 were observed on the right condyle. The predominant cause of MCF was RTA (n\u0026thinsp;=\u0026thinsp;92), succeeded by falls (n\u0026thinsp;=\u0026thinsp;22) and physical assault (n\u0026thinsp;=\u0026thinsp;8). When it came to the causes of fractures, the chi-square test revealed that there was no statistically significant difference between the two sexes. This was the conclusion reached by the researchers. Furthermore, the t-test findings revealed no notable correlation between the aetiology of fractures and age across both genders (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cb\u003eSex and age distribution according to different etiologies\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"7\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eEtiology\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u003cp\u003eSex distribution (n\u0026thinsp;=\u0026thinsp;122)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eP-value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eMale (mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eFemale (mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eP-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eRoad traffic accident\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e70 (74.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e22 (78.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.658\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e31.46\u0026thinsp;\u0026plusmn;\u0026thinsp;11.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e30.77\u0026thinsp;\u0026plusmn;\u0026thinsp;11.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.809\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eFalling down\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e16 (17.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6 (21.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.594\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e28.69\u0026thinsp;\u0026plusmn;\u0026thinsp;11.38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e28.68\u0026thinsp;\u0026plusmn;\u0026thinsp;15.83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.997\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAssault\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e8 (8.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.110\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e29.50\u0026thinsp;\u0026plusmn;\u0026thinsp;6.74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eAmong the various classifications of MCF, MacLennan class III emerged as the most prevalent, with a total of 56 instances, accounting for 36.6% of the cases. In contrast, MacLennan class I represented the least common type, with only 13 occurrences, which corresponds to 8.5%. The findings of the chi-square test suggested that there was no statistically significant correlation between the aetiology and the kind of fractures (p\u0026thinsp;=\u0026thinsp;0.706) (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). This was the conclusion reached by the researchers.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cb\u003eType and location of the fractures according to different etiologies\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"10\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eEtiology\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e\u003cp\u003eMacLennan class of fractures (n\u0026thinsp;=\u0026thinsp;153)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c10\" namest=\"c7\"\u003e\u003cp\u003eLocation of fractures (n\u0026thinsp;=\u0026thinsp;153)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eI\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003eII\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003eIII\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003eIV\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003eP-value\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eCondylar head\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eCondylar neck\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eSubcondylar\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003eP-value\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eRTA\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e12\u003c/p\u003e\u003cp\u003e(7.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e31\u003c/p\u003e\u003cp\u003e(20.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e41\u003c/p\u003e\u003cp\u003e(26.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e36\u003c/p\u003e\u003cp\u003e(23.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.706\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e8\u003c/p\u003e\u003cp\u003e(5.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e51\u003c/p\u003e\u003cp\u003e(33.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e61\u003c/p\u003e\u003cp\u003e(39.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.292\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eFalling down\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003cp\u003e(0.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7\u003c/p\u003e\u003cp\u003e(4.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10\u003c/p\u003e\u003cp\u003e(6.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e7\u003c/p\u003e\u003cp\u003e(4.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1\u003c/p\u003e\u003cp\u003e(0.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e12\u003c/p\u003e\u003cp\u003e(7.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e12\u003c/p\u003e\u003cp\u003e(7.8%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAssault\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003cp\u003e(0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003cp\u003e(0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5\u003c/p\u003e\u003cp\u003e(3.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3\u003c/p\u003e\u003cp\u003e(1.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0\u003c/p\u003e\u003cp\u003e(0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e6\u003c/p\u003e\u003cp\u003e(4.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e2\u003c/p\u003e\u003cp\u003e(1.3%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eIn light of the geographical context, the majority of fractures (n\u0026thinsp;=\u0026thinsp;75, 0%) were identified as subcondylar, succeeded by condylar neck fractures (n\u0026thinsp;=\u0026thinsp;69, 0%) and condylar head fractures (n\u0026thinsp;=\u0026thinsp;9, 0%). Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e displays the findings of the chi-square test, which indicated that there was no statistically significant correlation between the site of fractures and the aetiology of those fractures (p\u0026thinsp;=\u0026thinsp;0.292).\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e indicates that 91 fractures, accounting for 74.6%, were unilateral, while 31 fractures, representing 25.4%, were bilateral. The results of the chi-square test indicated a noteworthy correlation between the aetiology of fractures and the severity of injuries, specifically in the context of unilateral and bilateral condylar fractures (p\u0026thinsp;=\u0026thinsp;0.071).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cb\u003eFracture severity based on the injury's aetiology\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eEtiology\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u003cp\u003eSeverity of injury (n\u0026thinsp;=\u0026thinsp;122)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUF (n\u0026thinsp;=\u0026thinsp;91)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eBF (n\u0026thinsp;=\u0026thinsp;31)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eP-value\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eRTA\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e64 (70.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e28 (90.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.071\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eFalling down\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e19 (20.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3 (9.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAssault\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8 (8.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"4\"\u003eUF, unilateral fracture; BF, bilateral fracture; RTA, road traffic accident.\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe incidence of patients who experienced concomitant injuries alongside unilateral and bilateral condylar fractures has been enumerated and juxtaposed in Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e. Consequently, the incidence of symphysis and maxillary fractures was notably higher in patients exhibiting bilateral condylar fractures compared to those with unilateral fractures (p\u0026thinsp;=\u0026thinsp;0.017 and p\u0026thinsp;=\u0026thinsp;0.035, respectively). In contrast, the incidence of mandibular body fractures was significantly greater in cases of unilateral fractures compared to those with bilateral condylar fractures (p\u0026thinsp;=\u0026thinsp;0.015). This was true for both unilateral and bilateral fractures. When it came to the mandibular angle, there was a significant difference between individuals who had unilateral fractures and those who had bilateral fractures (p\u0026thinsp;=\u0026thinsp;0.064).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cb\u003eThe incidence of individuals with concomitant injuries related to unilateral and bilateral condylar fractures\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAssociated injuries\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNumber of patients with UF (n\u0026thinsp;=\u0026thinsp;91)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNumber of patients with BF\u003c/p\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;31)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;122)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eP-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMandibular fractures\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"4\" nameend=\"c5\" namest=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSymphysis\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e39 (42.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e21 (67.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e60 (49.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.017\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eBody\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e25 (27.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2 (6.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e27 (22.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.015\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAngle\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e11 (12.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e11 (9.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.064\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eRamus\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e5 (5.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2 (6.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e7 (5.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eCoronoid\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e3 (3.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1 (3.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4 (3.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMaxillary fractures\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e18 (19.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12 (38.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e30 (24.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.035\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eZygomatic fractures\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e16 (17.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6 (19.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e22 (18.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.825\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eNasal fractures\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e14 (15.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7 (22.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e21 (17.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.359\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003eUF, unilateral fracture; BF, bilateral fracture.\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eWhen it comes to cases involving condylar neck and sub-condylar fractures, the average angle of the fracture line in regard to the posterior border of the ramus was measured to be 120.85 11.14 degrees. According to the findings of the analysis of variance, there was not a statistically significant connection between the aetiology of the fracture and the mean fracture line angle (p\u0026thinsp;=\u0026thinsp;0.711) (Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e). This was the conclusion reached by scientists.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cb\u003eThe average angle of the fracture line with the posterior border of the ramus in instances of condylar neck and sub-condylar fractures based on the injury's source.\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEtiology\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAngle (Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eP-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eRoad traffic accident\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e120.83\u0026thinsp;\u0026plusmn;\u0026thinsp;11.79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.711\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eFalling down\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e121.98\u0026thinsp;\u0026plusmn;\u0026thinsp;8.26\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAssault\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e118.13\u0026thinsp;\u0026plusmn;\u0026thinsp;11.20\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eEpidemiological studies of condylar fractures can effectively understand the pattern of these fractures and implement preventive policies (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). The present study on MCF indicated the most involved age groups, prevalence of different etiologies, locations, types of fracture, frequency of the patients sustaining the associated injuries, and the mean of fracture line angle.\u003c/p\u003e\u003cp\u003eIn the present study, the male/female ratio was 3.35:1, which was similar to that found in other studies (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e), but greater than the ratio reported by Marker et al (2:1) (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Additionally, the mean age of the patients was 30.7 years, which was in agreement with the studies carried out by Silvennoinen et al (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e), Marker et al (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e), and Sawazaki et al (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Furthermore, the 21\u0026ndash;30 age group was more prone to condylar fractures, which was in line with the findings of other reports (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). The current study findings revealed no significant relationship between age group and sex ratio. However, Zhou et al showed a decrease in the male/female ratio in the 11\u0026ndash;20 age group compared to other age groups. This may be because women in the 11\u0026ndash;20 age group play active societal roles. Besides, around the age of puberty, they suffer from MCF almost as much as men do. Nonetheless, the male/female ratio markedly increased in the patients aged 21\u0026ndash;30. This may be attributed to the change in the roles played by men and women in the 21\u0026ndash;30 age group. In this age group, men are more active in the workplace, while women are more preoccupied with childbirth and childcare (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e).\u003c/p\u003e\u003cp\u003ePrevious studies have demonstrated different etiologies of MCF in various countries. Violence has been identified as the most common aetiology in Scotland (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) and Finland (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). In addition, falls are the most common cause in Sri Lanka (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). However, recent studies have indicated that RTA has been the most common cause of condylar fractures in developed and developing countries (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). RTA was also the leading cause of trauma in the current investigation. The disparity in outcomes observed in the current study and those of other studies can be attributed to population mobility, careless driving, unsafe roads, improper road traffic policies, unsafe cars, discrepancies in geographical areas, people's socioeconomic status, and date of injury.\u003c/p\u003e\u003cp\u003eLoukota et al (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e) a straightforward and accurate method for classifying condylar fractures was proposed. In this classification, condylar fractures have been divided into three categories, namely condylar head, condylar neck, and subcondylar fractures. In the current research, the most frequent fractures were subcondylar (49%), followed by condylar neck (45%) and condylar head (6%) fractures. Similar results were also obtained by Zachariades et al (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e), Sawazaki et al (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e), and Reddy et al (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). However, condylar head fractures are most common in a few studies (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). Moreover, several studies demonstrated that the location of condylar fractures was directly affected by the cause of the injury (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). According to Marker et al (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e), condylar head fractures occurred more frequently in cases where considerable force was involved. In other words, sub-condylar fractures were more likely to occur when the damage was caused by a weak force (alleged assault). The present study results revealed no significant relationship between the aetiology and location of the fractures. However, there were no patients under 12 in this study. Children are more prone to condylar head fractures (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eMacLennan (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e) classified the types of fractures into four groups. In the current study, MacLennan's class III was the predominant type of MCF (36.6%), consistent with other studies' results (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). On the contrary, Zhou et al (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e) disclosed that class IV was the most common type of MCF. Research indicates that severe fractures (MacLennan's class IV) are more prevalent in instances resulting from high-velocity accidents, such as falls and road traffic accidents (RTA). In contrast, MacLennan's class I and II condylar fractures typically resulted from assaults characterised by lower force intensities (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). The current investigation did not find any evidence of a substantial connection between the aetiology and the kind of fractures it examined.\u003c/p\u003e\u003cp\u003eThe study findings demonstrated that bilateral fractures occurred slightly more frequently when a considerable force was applied (RTA). In contrast, unilateral fractures occurred when a weak force was applied (alleged assault). Similar results were obtained by Marker et al (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn the present study, individuals with concomitant mandibular fractures with condylar fractures comprised 68% of the sample. The most commonly associated mandibular fracture with condylar fracture was symphysis fractures, followed by mandibular body fractures. These findings were consistent with those of the previous studies conducted on the issue (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). In the present study, symphysis fractures were found more frequently in the cases with bilateral condylar fractures, which was in line with the findings of the study by Zhou et al. (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). Nevertheless, body fractures occurred more often in instances with unilateral condylar fractures compared to those with bilateral condylar fractures. The fracture angle was marginally elevated in instances of unilateral condylar fractures. Zhou et al (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e) did not find any significant relationships between mandibular body fractures and the severity of condylar fractures (unilateral or bilateral condyle fractures).\u003c/p\u003e\u003cp\u003eNonetheless, they observed a significant relationship between mandibular angle fractures and the fracture severity (unilateral or bilateral condyle fracture). Generally, the mandibular body and angle fractures absorb a part of the applied force, causing unilateral fractures. However, the force exerted on the mandibular body and angle can be transmitted along the mandibular arch, leading to contralateral condyle fracture. In the research by Zhou et al (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e), no significant relationship was observed between maxillary fracture and fracture severity (unilateral or bilateral condyle fracture). However, this relationship was significant in the current study. Accordingly, maxillary fracture was more frequent in the patients with bilateral condylar fractures. In individuals with bilateral condylar fractures, significant strain is exerted on the head and face, leading to maxillary fracture.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe findings of the current investigation indicated that road traffic accidents were the predominant cause of mandibular condylar fractures. The findings indicated no substantial correlation between the different sources of condylar fractures and gender, age, as well as the location and type of fractures. The subcondylar region was the predominant site for condylar fractures, with MacLennan class III being the most prevalent form. Furthermore, symphysis and maxillary fractures were more prevalent in individuals with bilateral condylar fractures compared to those with unilateral condylar fractures. In contrast, mandibular body fractures occurred more often in instances with unilateral fractures compared to those with bilateral condylar fractures.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003e\u003cstrong\u003eConflict of interest:\u003c/strong\u003e\u003c/h2\u003e\n\u003ch2\u003eFunding :\u003c/h2\u003e\n\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\n\u003cp\u003eConceptualization: Azita Sadeghzade.Study design \u0026amp; methodology: Azita Sadeghzade; Maryam Paknahad; Hossein Daneste.Ethics approval \u0026amp; project administration: Azita Sadeghzade.Resources \u0026amp; patient management: Hossein Daneste.Data curation (chart extraction, registry abstraction): Reza Daryani; Maryam Paknahad.Imaging acquisition/interpretation (CT classification; angle measurements): Maryam Paknahad.Validation (case verification; classification cross-check): Hossein Daneste; Maryam Paknahad.Formal analysis \u0026amp; statistics (chi-square, t-test, ANOVA): Maryam Paknahad; Azita Sadeghzade.Visualization (tables/figures): Maryam Paknahad.Writing \u0026ndash; original draft: Maryam Paknahad; Reza Daryani.Writing \u0026ndash; review \u0026amp; editing (critical revision for intellectual content): Azita Sadeghzade; Hossein Daneste; Maryam Paknahad.Supervision: Azita Sadeghzade.Guarantor: Azita Sadeghzade accepts full responsibility for the integrity of the work as a whole.All authors read and approved the final manuscript and agree to be accountable for all aspects of the work.Corresponding author: Azita Sadeghzade, Oral and Dental Disease Research Center, Department of Oral and Maxillofacial Medicine, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran. Telefax: +98-71-36263193; E-mail: [email protected]\u003c/p\u003e\n\u003ch2\u003eAcknowledgement:\u003c/h2\u003e\n\u003cp\u003eThe authors would like to thank Ms. A. Keivanshekouh at the Research Consultation Center (RCC) of Shiraz University of Medical Sciences for improving the use of English in the manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eIida S, Kogo M, Sugiura T, Mima T, Matsuya T. Retrospective analysis of 1502 patients with facial fractures. International journal of oral and maxillofacial surgery. 2001;30(4):286-90.\u003c/li\u003e\n\u003cli\u003eAmaratunga NdS. A study of condylar fractures in Sri Lankan patients with special reference to the recent views on treatment, healing and sequelae. British Journal of Oral and Maxillofacial Surgery. 1987;25(5):391-7.\u003c/li\u003e\n\u003cli\u003eEllis E, Moos KF, El-Attar A. Ten years of mandibular fractures: an analysis of 2,137 cases. Oral surgery, oral medicine, oral pathology. 1985;59(2):120-9.\u003c/li\u003e\n\u003cli\u003eMarker P, Nielsen A, Bastian HL. Fractures of the mandibular condyle. Part 1: patterns of distribution of types and causes of fractures in 348 patients. British journal of oral and maxillofacial surgery. 2000;38(5):417-21.\u003c/li\u003e\n\u003cli\u003eSawazaki R, J\u0026uacute;nior SML, Asprino L, Moreira RWF, De Moraes M. Incidence and patterns of mandibular condyle fractures. Journal of Oral and Maxillofacial Surgery. 2010;68(6):1252-9.\u003c/li\u003e\n\u003cli\u003eSilvennoinen U, Iizuka T, Lindqvist C, Oikarinen K. Different patterns of condylar fractures: an analysis of 382 patients in a 3-year period. Journal of oral and maxillofacial surgery. 1992;50(10):1032-7.\u003c/li\u003e\n\u003cli\u003eZachariades N, Koumoura F, Konsolaki-Agouridaki E. Facial trauma in women resulting from violence by men. Journal of oral and maxillofacial surgery. 1990;48(12):1250-3.\u003c/li\u003e\n\u003cli\u003eZachariades N, Papavassiliou D, Koumoura F. Fractures of the facial skeleton in children. Journal of Cranio-Maxillofacial Surgery. 1990;18(4):151-3.\u003c/li\u003e\n\u003cli\u003eVillarreal PM, Monje F, Junquera LM, Mateo J, Morillo AJ, Gonz\u0026aacute;lez C. Mandibular condyle fractures: determinants of treatment and outcome. Journal of oral and maxillofacial surgery. 2004;62(2):155-63.\u003c/li\u003e\n\u003cli\u003eZachariades N, Mezitis M, Mourouzis C, Papadakis D, Spanou A. Fractures of the mandibular condyle: a review of 466 cases. Literature review, reflections on treatment and proposals. Journal of Cranio-Maxillofacial Surgery. 2006;34(7):421-32.\u003c/li\u003e\n\u003cli\u003eLaskin DM. Establishing new standards. Journal of Oral and Maxillofacial Surgery. 1991;49(11):1141.\u003c/li\u003e\n\u003cli\u003eLindahl L, Hollender L. Condylar fractures of the mandible: II. A radiographic study of remodeling processes in the temporomandibular joint. International journal of oral surgery. 1977;6(3):153-65.\u003c/li\u003e\n\u003cli\u003eZhang X, Obeid G. A comparative study of the treatment of unilateral fractured and dislocated mandibular condyles in the rabbit. Journal of oral and maxillofacial surgery. 1991;49(11):1181-90.\u003c/li\u003e\n\u003cli\u003eMacLennan W. Consideration of 180 cases of typical fractures of the mandibular condylar process. Journal of Plastic, Reconstructive \u0026amp; Aesthetic Surgery. 1949;5(2):122-8.\u003c/li\u003e\n\u003cli\u003eSriraam KG, Vignesh KRA. Diagnosis and management of mandibular condyle fractures. Oral and Maxillofacial Surgery: IntechOpen; 2021.\u003c/li\u003e\n\u003cli\u003eARSHAD BADAR M, ALI SHAH SA, WAHID A. ETIOLOGY OF MANDIBULAR CONDYLAR FRACTURES; A STUDY FROM TERTIARY CARE HOSPITAL OF LAHORE. Pakistan Oral \u0026amp; Dental Journal. 2014;34(1).\u003c/li\u003e\n\u003cli\u003eOrtiz-Guti\u0026eacute;rrez AL, Beltr\u0026aacute;n-Salinas B, Cienfuegos R. Mandibular condyle fractures: A diagnosis with controversial treatment. Cirug\u0026iacute;a y cirujanos. 2019;87(5):587-94.\u003c/li\u003e\n\u003cli\u003eSawhney R, Brown R, Ducic Y. Condylar fractures. Otolaryngologic Clinics of North America. 2013;46(5):779-90.\u003c/li\u003e\n\u003cli\u003ePapadaki ME, Tayebaty F, Kaban LB, Troulis MJ. Condylar resorption. Oral and maxillofacial surgery clinics of North America. 2007;19(2):223-34.\u003c/li\u003e\n\u003cli\u003eIftikhar B, Zulfiqar G, Azam M, Ahmad M. Effect of treating Mid-Face fracture on nutritional status. The Professional Medical Journal. 2024;31(03):473-9.\u003c/li\u003e\n\u003cli\u003eKuna SK, Jain A, Kuna V. Two Miniplates Versus Three Dimensional Plate in Management of Mandibular Condylar Fractures: A Systematic Review and Meta-Analysis. Craniomaxillofacial Trauma \u0026amp; Reconstruction. 2024:19433875241252979.\u003c/li\u003e\n\u003cli\u003eKeyhan SO, Damsaz M. Historical Overview of Oral and Maxillofacial Surgery: The Bridge Between Medicine and Dentistry. Handbook of Oral and Maxillofacial Surgery and Implantology: Springer; 2024. p. 1-23.\u003c/li\u003e\n\u003cli\u003eLoukota R, Eckelt U, De Bont L, Rasse M. Subclassification of fractures of the condylar process of the mandible. British journal of oral and maxillofacial surgery. 2005;43(1):72-3.\u003c/li\u003e\n\u003cli\u003eZhou H-H, Liu Q, Cheng G, Li Z-B. Aetiology, pattern and treatment of mandibular condylar fractures in 549 patients: a 22-year retrospective study. Journal of Cranio-Maxillofacial Surgery. 2013;41(1):34-41.\u003c/li\u003e\n\u003cli\u003eReddy NVV, Reddy PB, Rajan R, Ganti S, Jhawar D, Potturi A. Analysis of patterns and treatment strategies for mandibular condyle fractures: review of 175 condyle fractures with review of literature. Journal of maxillofacial and oral surgery. 2013;12(3):315-20.\u003c/li\u003e\n\u003cli\u003eHe D, Yang C, Chen M, Jiang B, Wang B. Intracapsular condylar fracture of the mandible: our classification and open treatment experience. Journal of oral and maxillofacial surgery. 2009;67(8):1672-9.\u003c/li\u003e\n\u003cli\u003eZhou H-H, Lv K, Yang R-T, Li Z, Yang X-W, Li Z-B. Mandibular condylar fractures in children and adolescents: 5-Year retrospective cohort study. International journal of pediatric otorhinolaryngology. 2019;119:113-7.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Mandibular fracture, Mandibular angle, Unilateral, Bilateral, Trauma","lastPublishedDoi":"10.21203/rs.3.rs-7814440/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7814440/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjective\u003c/h2\u003e\u003cp\u003eThis research sought to examine the aetiology and pattern of Mandibular Condylar Fractures (MCF).\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eData on patients who had MCF from 2018 to 2020 were documented, including fracture aetiology, site, kind, fracture line angle, and concomitant injuries. The data were further analysed with the chi-square test, t-test, and ANOVA.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eThis research included 122 patients (94 men and 28 females), yielding a male-to-female ratio of 3.35:1 and an average age of 30.7 years. Road traffic accidents was the predominant cause of fractures, accounting for 75.4%. Of the 153 fractures, 75 (49.01%) were categorised as subcondylar fractures, 69 (45.09%) as condylar neck fractures, and 9 (5.9%) as condylar head fractures. Among several forms of MCF, MacLennan class III was the most frequent (n\u0026thinsp;=\u0026thinsp;56, 36.6%), whereas MacLennan class I was the least common type of fracture (n\u0026thinsp;=\u0026thinsp;13, 8.5%). Moreover, symphysis and maxillary fractures were more prevalent in individuals with bilateral condylar fractures compared to those with unilateral condylar fractures (p\u0026thinsp;=\u0026thinsp;0.017 and p\u0026thinsp;=\u0026thinsp;0.035, respectively). On the other hand, individuals who had unilateral condylar fractures were more likely to have mandibular body fractures than those who had bilateral condylar fractures (p\u0026thinsp;=\u0026thinsp;0.015). In cases where the condylar neck and sub-condylar fractures were present, the average angle of the fracture line with the posterior border of the ramus was 120.85 11.14 degrees.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eA motor traffic collision was the predominant aetiology of MCF. The findings indicated a substantial correlation between the severity of condylar fractures and the concomitant injuries.\u003c/p\u003e\u003ch2\u003eClinical Trial Number:\u003c/h2\u003e\u003cp\u003eIR.SUMS.DENTAL.REC.1399.120\u003c/p\u003e","manuscriptTitle":"Aetiology and pattern of 122 patients with mandibular condylar fracture","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-17 10:17:31","doi":"10.21203/rs.3.rs-7814440/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"169eafe0-8556-4ab6-bea6-7de9c92c8c68","owner":[],"postedDate":"November 17th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-11-17T10:17:34+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-17 10:17:31","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7814440","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7814440","identity":"rs-7814440","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}