[Mandibular condyle fractures: conservative treatment versus surgical treatment]

A review of medical literature on the various principles of medical care of condylar fractures confirms that the treatment is still controversial. For a long period of time, the conservative functional treatment of condylar fractures was a dominant philosophy. However, rigid internal fixation of condylar fractures is increasingly accepted as an alternative which presents an improved stability provided by the use of plate and screw fixation techniques. The purpose of this study is to compare the clinical and radiographic long-term results of patients with condylar fractures treated between 1984 and 1992 in our department. 51 patients were treated in a conservative functional way. Rigid internal fixation was performed in 25 patients using an intraoral approach, according to a technique described by Steinhäuser in 1964. The results of this retrospective analysis indicate that in fractures of the condylar head a conservative functional treatment is the therapy of choice. Fractures of the subcondylar region and also--in selected clinical circumstances--fractures of the condylar neck represent indications for a carefully executed rigid internal fixation. The intraoral approach has been proved to cause minimal morbidity and complications.