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Open reduction without fixation of dislocated condylar process fractures: long-term clinical and radiologic analysis
T Iizuka1, K Lädrach, A H Geering
1Department of Cranio-Maxillofacial Surgery, School of Dental Medicine, University Hospital of Bern (Inselspital), Switzerland.
Purpose:
This study evaluates the long-term results of open reduction without fixation for displaced fractures of the condylar process.
Patients And Methods:
Clinical and radiologic examinations were performed on 27 patients with 29 operated joints an average of 6.7 years postoperatively. The postoperative result was evaluated on the basis of occlusal and joint function, as well as radiographic assessment of condylar changes.
Results:
Clinically, satisfactory results were achieved. Radiologically, despite correct intraoperative alignment of the fractured segments, a slight medial deviation of the condylar process was found on the posteroanterior radiograph. However, in only two cases was a 20-degree deviation observed. On final follow-up, 48% of the cases had a normal condylar configuration radiologically, and in the remaining cases, normal function was established even though there were condylar changes. Fully exposed and devascularized condylar processes generally showed more severe changes than those in which partial vascularization was maintained.
Conclusion:
The surgical management described enables a satisfactory outcome to be achieved with dislocated condylar process fractures.