A preliminary report of arthroscopic findings following acute condylar trauma

Standard therapy in orthopedics dictates that joints with suspected hemarthrosis be considered for irrigation or exploration, especially when immobilization is part of the treatment plan. In this preliminary report, 14 patients who had condylar/subcondylar fractures underwent superior joint space arthroscopy as part of the evaluation and treatment of their fractures. In all but two patients, blood was found in the superior joint space. Length of time from injury to time of examination correlated with the quantities of blood found. The severity and direction of the blow seemed to influence the findings in the joints. Synovial ecchymosis was a consistent finding. The disc appeared to be grossly intact and within the glenoid fossa in all cases, even when the condyle was grossly displaced. These findings raise questions about the role of direct disc injury as a source of postoperative temporomandibular joint (TMJ) symptoms, as well as about the practice of immobilization of fractures immediately after trauma. Further studies will be necessary to compare the treatment results in patients who have had arthroscopy versus those who have not.