Condylar Fractures: Surgical Versus Conservative Management
Abhishek Karan1, N S Kedarnath2, G Santhosh Reddy3
1Department of Oral and Maxillofacial Surgery, Saraswati-Dhanwantari Dental College and Hospital and Post-Graduate Research Institute, Parbhani, Maharashtra, India.
Annals of Maxillofacial Surgery
|July 12, 2019
Summary
Surgical treatment of moderately displaced condylar fractures leads to better outcomes than conservative management. Surgery offers improved mouth opening, reduced pain, and better ramus height restoration within six weeks.
Area of Science:
- Oral and Maxillofacial Surgery
- Traumatology
- Orthodontics
Background:
- Condylar fractures are common facial injuries.
- Treatment options include conservative (closed reduction) and surgical (open reduction and internal fixation) methods.
- Both modalities have distinct indications, contraindications, and outcomes.
Purpose of the Study:
- To compare the efficacy of surgical versus conservative management for moderately displaced subcondylar and condylar neck fractures.
- To evaluate functional and radiographic outcomes between the two treatment groups.
Main Methods:
- A randomized study of 20 adult patients with moderately displaced condylar fractures.
- Patients were divided into non-surgical and surgical groups.
- Outcomes assessed included mouth opening, mandibular movements, occlusion, deviation, pain (VAS), and ramus height (radiographic) over a 6-week follow-up.
Main Results:
- Surgical group showed significantly better maximal interincisal mouth opening and lateral excursions.
- Patients undergoing surgery experienced earlier pain relief and minimal mandibular deviation.
- Radiographic assessment revealed superior restoration of ascending ramus height and symmetry in the surgical group (P < 0.05).
Conclusions:
- Surgical management is preferable for moderately displaced condylar fractures compared to conservative treatment.
- The study highlights the benefits of surgical intervention for functional and aesthetic recovery.
- Further research with larger cohorts is recommended for definitive conclusions.
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