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Outcome Assessment of Closed Treatment for Bilateral Subcondylar Fractures
Adir Cohen1, Keidar Zar2, Shira Gat3
1Department of Oral and Maxillofacial Surgery, Hebrew University-Hadassah, Jerusalem, Israel.
Study Design:
This retrospective study assessed the long-term outcomes of closed treatment (CT) using intermaxillary fixation (IMF) for bilateral subcondylar mandibular fractures. It included 30 patients treated with IMF for 6 weeks (study group) and 29 controls without temporomandibular joint (TMJ) disorders. Clinical assessments included mandibular function, pain, facial symmetry, and occlusion, while radiographic evaluations measured condylar deviation and vertical height reduction (VHR). Fracture severity and patient age at trauma were analyzed as influencing factors.
Methods:
The study group underwent 6 weeks of IMF treatment. Outcomes such as maximal mouth opening (MMO), mandibular and chin deviation, TMJ pain, masticatory muscle pain, condylar deviation, and VHR were compared with controls. Severe fractures were defined as VHR >5 mm or angulation >45 degrees, with results stratified by age (younger than 12 y versus older).
Results:
MMO was similar between groups; however, the study group had higher rates of mandibular deviation (1.87±2.12 mm versus 0.38±0.31 mm; P =0.001), chin deviation (1.77±1.84 mm versus 0.14±0.51 mm; P <0.001), TMJ pain (13.33% versus 0%; P =0.041), and masticatory muscle pain (53.33% versus 0%; P <0.001). Severe fractures led to worse outcomes, while younger patients showed better recovery.
Conclusions:
CT with IMF achieves satisfactory long-term results with minimal complications but is influenced by fracture severity and age.
