Does ORIF Yield Favourable Outcomes in Condylar Head Fractures? A Prospective Analysis of 76 Cases

Mandibular condylar fractures, particularly condylar head fractures (CHFs), pose significant challenges due to their location within the temporomandibular joint (TMJ). The optimal management of CHFs remains controversial, with various treatment modalities available.

To evaluate the efficacy of open reduction and internal fixation (ORIF) for CHFs using an inviscision approach and fixation with one bicortical screw, two bicortical screws, and miniplates to assess post-operative outcomes and complications.

According to He et al., Type A, B 67 cases (76 joints) of condylar head fractures were treated for ORIF. The parameters like exposure and fixation times, types of fixations, disc repositioning/repair, mouth opening, bite force, occlusion, excursive movements, chin deviation, pain, fracture reduction and complications were monitored. Patient satisfaction score and scar formation were also evaluated.

Road traffic accidents were the primary cause of CHFs (46.27%). Average surgical exposure time was 13.12 min. Post-operative outcomes demonstrated significant improvements in mouth opening, bite force, and occlusal derangement. Radiographic evaluation revealed successful anatomical reduction in 76.32% of cases, with minimal complications like post-operative infection (9.21%) and transient facial nerve injury (22.37%). Overall, patient satisfaction score was 4 and the average score of 2 on Patient and Observer Scar Assessment Scale. Top of FormTop of Form.

A comprehensive approach incorporating aesthetic surgical techniques, precise fracture management, and disc repositioning is crucial for successful management of CHFs. ORIF using inviscision techniques, long bicortical screws, and miniplates presents a promising treatment modality for restoring TMJ function and achieving high patient satisfaction rates.