Purpose <p>The purpose of this study was to determine the accuracy of two conventional radiographic views, orthopantomogram and reverse Towne’s, versus computed tomography in the diagnosis of condylar fractures.</p> Methods <p>This prospective comparative study was carried out on 48 patients clinically diagnosed with unilateral or bilateral condylar fractures. The patients were subjected to orthopantomography (OPG) and reverse Towne’s views, followed by imaging with computed tomography (CT) scans. Depending on the two radiographic views which were perpendicular to each other, the authors attempted to classify condylar fractures based on Lindahl’s classification. The results from these two views were then compared to CT.</p> Results <p>With regards to diagnosing the level of condylar fracture and the relationship of the condylar segment to the mandibular fragment, the sensitivity of OPG and reverse Towne’s was 100%. With regards to the relationship between the condylar head and glenoid fossa, the sensitivity of OPG and reverse Towne’s was 81.25%, while the specificity for detecting displacement/dislocation was at 100%. A statistically significant difference was observed when comparing OPG and reverse Towne’s with CT for analyzing the relationship between the condylar head and glenoid fossa (<i>p</i> = 0.002).</p> Conclusion <p>Panoramic radiography and reverse Towne’s views can diagnose the level of condylar fracture and its relationship to the mandibular segment but cannot clearly discern the relationship of the fractured condyle to the glenoid fossa, whether displaced or dislocated. The authors conclude that CT imaging will undoubtedly aid in surgical planning but not necessarily affording an added benefit while planning conservative treatment.</p>

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Revisiting conventional radiography in the diagnosis of condylar fractures: a comparison with computed tomography

  • Godwin Alex Kiruba,
  • Thomas Zachariah

摘要

Purpose

The purpose of this study was to determine the accuracy of two conventional radiographic views, orthopantomogram and reverse Towne’s, versus computed tomography in the diagnosis of condylar fractures.

Methods

This prospective comparative study was carried out on 48 patients clinically diagnosed with unilateral or bilateral condylar fractures. The patients were subjected to orthopantomography (OPG) and reverse Towne’s views, followed by imaging with computed tomography (CT) scans. Depending on the two radiographic views which were perpendicular to each other, the authors attempted to classify condylar fractures based on Lindahl’s classification. The results from these two views were then compared to CT.

Results

With regards to diagnosing the level of condylar fracture and the relationship of the condylar segment to the mandibular fragment, the sensitivity of OPG and reverse Towne’s was 100%. With regards to the relationship between the condylar head and glenoid fossa, the sensitivity of OPG and reverse Towne’s was 81.25%, while the specificity for detecting displacement/dislocation was at 100%. A statistically significant difference was observed when comparing OPG and reverse Towne’s with CT for analyzing the relationship between the condylar head and glenoid fossa (p = 0.002).

Conclusion

Panoramic radiography and reverse Towne’s views can diagnose the level of condylar fracture and its relationship to the mandibular segment but cannot clearly discern the relationship of the fractured condyle to the glenoid fossa, whether displaced or dislocated. The authors conclude that CT imaging will undoubtedly aid in surgical planning but not necessarily affording an added benefit while planning conservative treatment.