Headless Cannulated Screws for the Treatment of Intracapsular Condylar Fracture: A Prospective Study

Numerous osteosynthesis techniques are available for the fixation of intracapsular condylar fractures but a definite gold standard method has yet to be established. Condyle consists of thin cortical bone with a friable cancelous centre and may not permit fixation with large and bulky hardware. Headless cannulated screws, often used in many forms of minimally invasive trauma surgery, provide functional and stable fracture fixation which can reduce the trauma to condylar fragments and surrounding soft tissue while treating intracapsular condylar fractures (ICF).

The present study proposes to assess the efficacy of headless cannulated screws in open reduction and internal fixation (ORIF) for the treatment of ICF of the mandible.

Six patients with ICF were treated by ORIF using a headless cannulated screw. Occlusion, maximum mouth opening (MMO), pain in TMJ at rest and while chewing, joint function using Helkimo's dysfunction index, radiographic outcome, and complications were recorded.

Mouth opening with and without pain after fixation increased significantly (from 22.33 ± 3.830 mm preoperatively to 38.83 ± 4.32 mm 3 months postoperatively), and all patients had satisfactory occlusion. Pain at rest and while chewing had significantly reduced. All six patients had severe TMJ dysfunction preoperatively, and they recovered by the 3rd follow-up month. The immediate postoperative CT scans of all patients showed an anatomic reduction of fractured fragments. The vertical ramus height restored was not statistically significant.

The study data suggested that there is a significant improvement in the clinical signs after ORIF of ICF using a headless cannulated screw.