Abstract
The choice of treatment for diacapitular condylar fractures remains in dispute among
oral and maxillofacial surgeons. A multivariate retrospective study was designed to
compare the prognosis after conservative treatment and surgery, and to explore further
indications for management. From 1 July 2013 to 30 June 2017, 169 patients with diacapitular
condylar fractures were included. Relevant preoperative data were collected, and the
prognoses assessed. Three ordinal logistic regression models were constructed to study
the factors that affected prognosis, and these showed that all patients treated by
open reduction and internal fixation (ORIF) tended to have a better prognosis than
those treated with conservative treatment (adult: odds ratio (OR) = 6.166, p = 0.000, and children: OR = 12.195, p = 0.029). Adult patients with lateral dislocation of the stump of the ramus out of the
glenoid fossa tended to have the highest risk of a poor prognosis, followed by those
with anteromedial displacement of the disc and loss of the height of the ramus of
over 5 mm. Only the type of treatment affected the prognosis for children. In conclusion,
these findings suggest that ORIF is the preferred method of treatment for patients
with diacapitular condylar fractures. The absolute indications for ORIF in adult patients
with diacapitular condylar fractures include lateral dislocation of the stump of the
ramus out of the glenoid fossa, anteromedial displacement of the disc, and loss of
height of the ramus of over 5 mm. There are no absolute indications for ORIF in children.
Keywords
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Article Info
Publication History
Published online: September 11, 2019
Accepted:
August 28,
2019
Identification
Copyright
© 2019 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
