Surgical treatment of condylar process fractures using axial anchor screw fixation: a preliminary follow-up study

The aim of this study was to evaluate use of the axial anchor screw system in the treatment of condylar process fractures.

Seven adult patients with displaced condylar process fractures were treated using axial anchor screw fixation. Indications for surgery were severe dislocation of the condyle and occlusal changes. Clinical and radiologic examinations were performed 6 weeks, 6 months, and approximately 2 years postoperatively (range, 18 to 30 months). Clinical factors recorded were occlusion, range of mandibular movement, and findings on palpation of the temporomandibular joints. Ramus height and angulation between the mandibular ramus and the dislocated condyle were measured and compared with the contralateral side preoperatively and at the last follow-up.

The postoperative course was uneventful in most patients. All were free of pain, and the occlusion and facial symmetry were normal. Radiographs generally showed excellent fracture reduction. Translation of the condyles on mouth opening was symmetrical. No signs of resorption or osteoarthrosis were evident in most cases. However, some patients had complications. These involved unsatisfactory reduction in one patient causing osteolysis at the fracture line. In another patient bone over the screw fractured and the condyle and the screw tilted in a medial direction.

Treatment of condylar process fractures using the axial anchor screw system is ideal in certain cases. The complications and difficulties seen may be avoidable by appropriate patient selection and techniques.