Unilateral condylar fracture with review of treatment modalities in 30 cases - An evaluative study

Abstract

Introduction: The treatment of subcondylar mandible fractures is a topic of debate and can be variable even though these fractures are commonly seen. The present study aimed at evaluation of various treatment modalities for unilateral condylar fracture in adults. Materials and Methods: Thirty patients with unilateral condylar fractures between the age of 18 and 60 years were evaluated. Treatment protocol included closed reduction for 15 patients and open reduction for 15 patients. Results: Assessment was done functionally for maximum interincisal mouth opening, deviation on maximum interincisal mouth opening, occlusion and facial nerve function, and radiologically for ramus height shortening. In general, there were no statistically significant differences between closed and open methods. Discussion: Both the treatment options for condylar fractures of the mandible yielded acceptable results. Closed treatment appears to be a safe and appropriate modality for most unilateral condylar fractures. Although the open group, in general, showed similar outcomes, this treatment should be reserved for limited indications. The present study has confirmed that both treatment options can yield acceptable results. On clinical examination, there was no significant difference in mouth opening measures, the incidence of occlusal disturbances or in the degree of pain perception.

Comparative evaluation of open reduction and internal fixation using delta plate versus conservative treatment in management of mandibular subcondylar fractures in adults

“…Facial expression weakness occurs in patients treated via this approach, which may be due to trauma during retraction rather than nerve damage. 13,19 In our study none of the patient observed with facial nerve palsy in open reduction group.…”

“…The conservative treatment is described as safe, non-invasive, easy, and low cost, but they have also reported many complications including poor oral hygiene, gingivitis, facial deformity, TMJ dysfunction, and even TMJ ankylosis. [13][14][15][16] Surgical treatment also has disadvantages such as its high cost, intraoperative hemorrhage, facial nerve injury, and other surgical complications along with post-operative scar formation. 13 The literature on condylar fractures has reported good outcomes for both open and closed treatment methods.…”

“…[13][14][15][16] Surgical treatment also has disadvantages such as its high cost, intraoperative hemorrhage, facial nerve injury, and other surgical complications along with post-operative scar formation. 13 The literature on condylar fractures has reported good outcomes for both open and closed treatment methods. [14][15][16] In our prospective clinical trial, we compared the outcome of open reduction with rigid internal fixation using delta plates versus conservative treatment of mandibular subcondylar fracture in adults and following parameters were measured.…”

“…The retromandibular approach provides a very satisfactory exposure for most condylar fractures. 1,13,18 Retromandibular approach was the choice of approach in our study as operating site is at a much shorter distance from the incision to the condyle. We found this approach to be more suitable to other approaches (preauricular, submandibular, intraoral, and rhytidectomy) due to following reasons: shorter working distance from the incision to the condylar region, greater access availability as the tissue can be retracted till the level of sigmoid ach, excellent exposure even on a face with marked edema, negligible chances of damage to the TMJ capsule, and the facial scar in less conspicuous location.…”

“…26 Similar results were observed by other authors. 13,27,28 Pain is a subjective experience reported by the patients. Postoperative pain was assessed by VAS scale.…”