Outcomes of surgical versus nonsurgical treatment of mandibular condyle fractures

Authors

  • Karthik Ragupathy Department of Dentistry, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry, India

DOI:

https://doi.org/10.18203/2349-2902.isj20151508

Keywords:

Condyle fracture, Open reduction, Closed reduction

Abstract

Background: The purpose of the present study was to analyze the outcome result of surgical and nonsurgical treatment of mandibular condyle fractures in patients treated at the Department of Oral and maxillofacial surgery, Sree Balaji Dental College and Hospital.

Methods: A retrospective study of 27 patients treated for mandibular condyle fractures at Department of Oral and maxillofacial surgery, Sree Balaji Dental College and Hospital between 2008-2010 was performed. Sixteen patients were treated nonsurgically and 11 patients by surgical treatment. Outcome results on clinical and radiological parameters were evaluated during the follow up period.

Results: In nonsurgical group, 9 patients (56%) had loss of vertical ramus height and 6 patients (37.5%) had reduced mouth opening of below 35 mm. In open reduction group temporary facial nerve weakness was seen in 2 patients (18%) and one patient developed post operative infection. None of the patients in both groups had malocclusion.

Conclusions: The study concludes that nonsurgical treatment gives satisfactory clinical results, though the condyle is not anatomically normal in radiographs, whereas surgical treatment provided more accurate results clinically as well as radiographically.

Metrics

Metrics Loading ...

References

Peterbanks. Killey’s fracture of the mandible. 4th edition. 94-106.

Rowe and Williams: Maxillofacial Injuries. Vol.1, 2nd edition, 405-415.

Valiati R, Ibrahim D, Abreu MER, Heitz C, De Oliveira RB, Pagnoncelli RM, et al. The treatment of condylar fractures: to open or not to open? A critical review of this controversy. Int J Med Sci. 2008;5(6):313-8.

Boss RR, Ward-Booth RP, De Bont LG. Mandibular condyle fractures: a consensus. Br J Oral Maxillofac Surg. 1999;37:87-9.

Santler G, Karcher H, Ruda C, Kole E. Fractures of the Condylar process: Surgical Versus Nonsurgical Treatment. J Oral Maxillofac Surg. 1999;57:392-7.

Ellis E, Dean J. Rigid fixation of mandibular condyle fractures. Oral Surg Oral Med Oral Pathol. 1993;76:6-15.

Ellis E. Complications of mandibular condyle fractures. Int. J. Oral Maxillofac. Surg. 1998;27:255-7.

Ellis E, Palmieri C, Throckmorton G. Further Displacement of Condylar Process Fractures after Closed Treatment. J Oral Maxillofac Surg. 1999;57:1307-16.

Ellis E, Throckmorton GS, Palmieri C. Open Treatment of Condylar Process Fractures: Assessment of Adequacy of Repositioning and Maintenance of Stability. J Oral Maxillofac Surg. 2000;58:27-34.

Ellis E, Simon P, Throckmorton GS. Occlusal Results After Open or Closed Treatment of Fractures of the Mandibular Condylar Process. J Oral Maxillofac Surg. 2000;58:260-8.

Ellis E, Throckmorton GS. Bite Forces after Open or Closed Treatment of Mandibular Condylar Process Fractures. J Oral Maxillofac Surg. 2001;59:389-95.

Ellis E, Throckmorton GS. Treatment of Mandibular Condylar Process Fractures: Biological Considerations. J Oral Maxillofac Surg. 2005;63:115-34.

Ellis E, Walker RV. Treatment of Malocclusion and TMJ Dysfunction Secondary to Condylar Fractures. Craniomaxillofac Trauma Reconstruction. 2009;2:1–18.

Hidding J, Wolf R, Pingel D. Surgical versus non-surgical treatment of fractures of the articular process of the mandible. Journal of Cranio-Maxillo-Facial Surgery. 1992;20:345-7.

Haug RH, Assael LA. Outcomes of Open Versus Closed Treatment of Mandibular Subcondylar Fractures. J Oral Maxillofac Surg. 2001;59:370-5.

Narayanan V, Kannan R, Sreekumar K. Retromandibular approach for reduction and fixation of mandibular condylar fractures: A clinical experience. Int J Oral Maxillofac Surg. 2009;38:835–9.

Tang W, Gao C, Long J, Lin Y, Wang H, Liu L. Application of Modified Retromandibular Approach Indirectly from the Anterior Edge of the Parotid Gland in the Surgical Treatment of Condylar Fracture. J Oral Maxillofac Surg. 2009;67:552-8.

Biglioli F, Colletti G. Mini-retromandibular approach to condylar fractures. Journal of Cranio-Maxillofacial Surgery. 2008;36:378-83.

Devlin MF, Hislop WS, Carton ATM. Open reduction and internal fixation of fractured mandibular condyles by a retromandibular approach: surgical morbidity and informed consent. British Journal of Oral and Maxillofacial Surgery. 2002;40:23-5.

Eckelt U, Schneider M, Erasmus F, Gerlach KL, Kuhlisch E, Loukota R, et al. Open versus closed treatment of fractures of the mandibular condylar process–a prospective randomized multi-centre study. Journal of Cranio-Maxillofacial Surgery. 2006.

Vesnaver A. Open Reduction and Internal Fixation of Intra-Articular Fractures of the Mandibular Condyle: Our First Experiences. J Oral Maxillofac Surg. 2008;66:2123-9.

Silvennoinen U, Iizuka T, Oikarinen K, Lindqvist C. Analysis of Possible Factors Leading to Problems after Nonsurgical Treatment of Condylar Fractures. J Oral Maxillofac Surg. 1994;52:793-9.

Danda AK, Muthusekar MR, Vinod Narayanan, Baig MF, Siddareddi A. Open Versus Closed Treatment of Unilateral Subcondylar and Condylar Neck Fractures: A Prospective, Randomized Clinical Study. J Oral Maxillofac Surg. 2010;68:1238-41.

De Riu G, Gamba U, Anghinoni M, Sesenna E. A comparison of open and closed treatment of condylar fractures: a change in philosophy. Int. J. Oral Maxillofac. Surg. 2001;30:384-9.

Worsae N, Thorn JJ. Surgical Versus Nonsurgical Treatment of Unilateral Dislocated Low Subcondylar a Clinical Study Fractures: of 52 Cases. J Oral Maxillofac Surg. 1994;52:353-60.

Downloads

Published

2016-12-13

Issue

Section

Original Research Articles