Current Concepts in the Mandibular Condyle Fracture Management Part I: Overview of Condylar Fracture

Abstract

The incidence of condylar fractures is high, but the management of fractures of the mandibular condyle continues to be controversial. Historically, maxillomandibular fixation, external fixation, and surgical splints with internal fixation systems were the techniques commonly used in the treatment of the fractured mandible. Condylar fractures can be extracapsular or intracapsular, undisplaced, deviated, displaced, or dislocated. Treatment depends on the age of the patient, the co-existence of other mandibular or maxillary fractures, whether the condylar fracture is unilateral or bilateral, the level and displacement of the fracture, the state of dentition and dental occlusion, and the surgeonnds on the age of the patient, the co-existence of othefrom which it is difficult to recover aesthetically and functionally;an appropriate treatment is required to reconstruct the shape and achieve the function ofthe uninjured status. To do this, accurate diagnosis, appropriate reduction and rigid fixation, and complication prevention are required. In particular, as mandibular condyle fracture may cause long-term complications such as malocclusion, particularly open bite, reduced posterior facial height, and facial asymmetry in addition to chronic pain and mobility limitation, great caution should be taken. Accordingly, the authors review a general overview of condyle fracture.

Anatomical Study of the Mandibular Angle and Body in Wide Mandibular Angle Cases

“…Mandibular angles vary among individuals [9]. A face shape with prominent malar and mandibular angles is thought to evoke beauty and youth and, thus, is preferred in the West; contrary to this, an oval and soft face shape is considered attractive in Asia [10].…”

The application of the Risdon approach for mandibular condyle fractures

“…Mandibular condyle fractures were classified according to the height of the fracture. Mandibular neck fractures occur below the joint capsule attachment but above the sigmoid notch, and subcondyle fractures run from the sigmoid notch to the back edge of the mandibular ramus [12]. According to the relationship between the proximal and the distal segments, the degree of condylar fracture is classified into non-displaced, deviated, or displaced fracture.…”

“…A non-displaced fracture has no displacement of the fracture site, a deviated fracture is where fracture segments are displaced but some of them contact, and a displaced fracture is where the fracture fragments are separated and the proximal and distal segments do not contact each other. Considering the relationship between the proximal segment and the temporal fossa, a dislocated fracture is one in which the condylar head is deviated from the temporal fossa [12]. …”

Mandibular Kondil Kırıkları ve Tedavi Yöntemleri

“…Söz konusu süre erişkinlerde 7-21 gün, çocuklarda 7-10 gündür 7 . Normal okluzyon sağlandıktan sonra yaklaşık 2 hafta kadar yumuşak diyet önerilmektedir 15 .…”

“…Kapalı redüksiyonun komplikasyonları; kırık segmentlerde iyileşememe veya yanlış iyileşme, ankiloz, malokluzyon, çenenin öne kaydırılmasında kısıtlanma, TME rahatsızlıkları, büyüme bozuklukları, kondil rezorpsiyonu, fasiyal asimetri, ve fonksiyonel bozukluklar olarak sıralanabilir 7,15,18 .…”