Conservative versus surgical management of mandibular condylar fractures: a comparative study

Condylar process fractures are a common mandibular injury predominantly affecting males, with a male-to-female ratio of 3:1. This study examines outcomes in patients with mandibular condylar fractures treated either conservatively or surgically, comparing long-term subjective results. A total of 281 cases were reviewed (144 treated conservatively and 137 treated surgically), with symptoms and functional outcomes assessed through questionnaires. Surgical intervention was more common in complex cases (e.g. bilateral fractures or concurrent maxillofacial injuries), and the surgical treatment group had a higher proportion of male patients and trauma related to violence. Mandibular joint sounds (e.g. clicking and crepitation) were more frequent in patients treated conservatively, whereas pain both at rest and during movement was more common in women and those with interpersonal violence-related trauma. Multivariable analysis indicated the presence of concurrent fractures as a risk factor for joint sounds, and gender and trauma type influenced pain and symptom frequency. Despite these differences, both treatments achieved comparable success in maintaining stable occlusion and achieving painless jaw function. These findings suggest that both conservative and surgical treatments can be effective, although individual factors such as gender, trauma type and concurrent fractures may affect post-treatment symptomatology and choice of treatment.