Condylar Fractures: An Argument for Conservative Treatment

Abstract

Introduction: The treatment of mandibular condyle fractures remains a controversial topic in maxillofacial surgery. No uniform treatment protocol is currently available. Purpose: We performed a retrospective monocentric cohort study of patients with condylar fractures and their treatment, including long-term follow-up by telephone, followed by a short review of the literature. Patients and Methods: The available data on condylar fractures presenting at Leuven University Hospitals between January 1, 2009, and December 31, 2015, were analyzed. Cause, age, sex, fracture level, degree of displacement, associated facial fractures, malocclusion, type of treatment, and complications were noted. Follow-up by telephone was performed after an average 261 weeks for the conservative group. Results: A total of 109 condylar fractures were observed with a male/female ratio of 1.14:1. Most fractures were subcondylar, unilateral, displaced, caused by road traffic accidents, and treated conservatively. Discussion: In children and intracapsular fractures, conservative management remains the first choice. Maxillomandibular fixation should be used sparingly in children and for as short a time as possible. Some patients indicated for surgery can still have acceptable results if treated conservatively.

comparative study between preauricular retromandibular anteroparotid approach and retromandibular transparotid approach in open reduction and internal fixation of subcondylar fracture on facial nerve injury and parotid fistula

“…As we go more forward this window raise. This surgical window is better when compared to the retromandibular approach (control group) thus resulting in smoother manipulation, less retraction, better viewing of facial branches thus good isolation and protection during dissection, concerning this advantage we share other authors conclusions (38)(39)(40) as well as (37).…”

“…Regarding scar; good aesthetic outcome of scar was found in all patients of the control group; 9(70%) cases had visible but thin and linear scar and 1(10%) case had wide scar at 3 and 6 months, in this group all patient were satisfied by their scar and this correspondent with (Fleix and Singh 2020) (35) while (Parihar et al 2019) (3) noticed five cases developed hypertrophic scarring. In this study/study group; we only had one case of transient facial paralysis, which could be attributed to the postgraduated clinician experience, and the small sample size, (Mohamad 2011, Khan and Sayed 2022) (36,37) encountered some cases of transient facial paralysis resulted from practising this approach.…”

The Treatment of Mandibular Condylar Fractures Using an Internal Distraction Device during a 7-year Period

“…Vanpoecke et al reported that 28 of 84 patients had mouth opening widths of less than 40 mm at 3 months after injury with conservative treatment alone 23) . Guerrero et al described in their meta-analysis that the mean mouth opening width with conservative treatment alone was 41.6 mm and that with ORIF was 41.4 mm 21) .…”

X-ray diagnosis of fractures of the condylar process of the lower jaw in children

“…Переломи нижньої щелепи (НЩ) є одними з найбільш частих і складних видів травматичних пошкоджень щелепно-лицевої ділянки в дітей і становлять 18-66% від загальної кількості переломів кісток обличчя [2,7]. Серед яких переломи НЩ у ділянці виросткових відростків зустрічаються в 25-40% випадків [1,9].…”