The effectiveness of guided botulinum toxin "A" injection to the masticatory muscles in the management of condylar and sub condylar fractures: a randomized controlled clinical trial

To evaluate the effectiveness of ultrasound guided injection of botulinum toxin A into the muscles of mastication; the masseter, temporalis and the lateral pterygoid, in a closed reduction approach of condylar and sub-condylar fractures, to optimize fracture reduction, reduce the length of intermaxillary fixation (IMF) and to facilitate postoperative functional recovery.

Sixteen medically healthy patients aged 18-35 years, presenting with unilateral subcondylar fracture were randomly assigned into two groups. The randomized controlled clinical trial was completed after recruitment, intervention, and follow up of all participants. The Study group (A) underwent an intervention involving ultrasound-guided Botulinum Toxin (BTX) injection into the Lateral Pterygoid Muscle (LPM), the Temporalis and the Masseter muscles, followed by the closed reduction treatment of the fracture, compared to the control group (B) that underwent conventional treatment method; the closed reduction approach without any BTX injections.