Musculoskeletal Analysis after Internal Fixation of Condylar Fracture: A Retrospective Study

Area of Science:

• Orthopedic Surgery
• Oral and Maxillofacial Surgery
• Biomedical Engineering

Background:

• Condylar fractures can lead to significant musculoskeletal modifications.
• Open reduction and internal fixation (ORIF) is a common treatment for condylar fractures.
• Understanding post-operative changes is crucial for refining surgical strategies.

Purpose of the Study:

• To evaluate musculoskeletal modifications following ORIF of condylar fractures.
• To correlate these modifications with fracture type, fixation method, and implant management.
• To provide data-driven guidance for clinical therapeutic decisions.

Main Methods:

• Retrospective study of 105 patients with unilateral condylar fractures treated with ORIF.
• Clinical assessments (mouth opening, mandible deviation, occlusion) and CT reconstructions (condyle volume, ramus height, muscle volumes) were performed.
• Comparisons were made between pre- and post-operative states, and across different fracture types, fixation methods, and implant retention statuses.

Main Results:

• ORIF significantly improved mouth opening, reduced mandible deviation, and corrected occlusal relationships.
• Higher fracture lines correlated with increased condylar bone resorption and masticatory muscle atrophy.
• Screw fixation resulted in more bone resorption than plate fixation.
• Implant retention negatively impacted ramus height and condyle volume; implant removal led to muscle atrophy.

Conclusions:

• Musculoskeletal modifications after ORIF are influenced by fracture characteristics, fixation choice, and implant removal decisions.
• Prolonged implant retention is linked to bone resorption; secondary surgery for removal may cause muscle atrophy.
• Findings suggest the development of non-removable implants with bone-like mechanical properties.