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Non-surgical treatment of condylar fractures in adults: a retrospective analysis
Luc M H Smets1, Philip A Van Damme, Paul J W Stoelinga
1Department of Oral and Cranio-Maxillofacial Surgery, University Medical Centre, Nijmegen, The Netherlands.
Purpose:
The aim of the study was to investigate the results of non-surgical treatment of condylar fractures in a group of 60 patients with 71 condylar fractures, in order to establish a protocol to select patients for surgical treatment of condylar fractures.
Material:
Out of a group of 91 patients treated in a non-surgical fashion, 60 patients with a total of 71 condylar fractures responded to the request for follow-up.
Methods:
Retrospective study, including clinical analysis of occlusion, asymmetry at rest and during mouth opening, maximum interincisal distance, signs of TMJ-dysfunction and analysis of radiographic data, i.e. shortening of the ascending ramus as measured on sequential orthopantomograms.
Results:
There were five patients (8%) with an unacceptable malocclusion of which one also had considerably limited mouth opening. Fifty-five patients (92%) had none or only minor signs of TMJ-dysfunction not requiring further treatment.
Conclusion:
Only in selected patients with shortening of the ascending ramus of 8mm or more and/or considerable displacement of the condylar fragment, surgical repositioning and rigid internal fixation should be considered.
