Abstract
Our aim was to evaluate the functional outcomes and complications of mandibular condylar
fractures managed surgically and non-surgically. Patients were identified retrospectively
from audit data and clinical records from 2005-2018, and functional outcomes were
evaluated based on the development of complications at clinical follow up. Patients
were categorised into three treatment groups: conservative (management with soft diet,
analgesia, and monitoring), closed (management with intermaxillary fixation), and
open reduction and internal fixation (ORIF). A total of 358 patients were included
with a median age of 33 years (mean 38), and a male:female ratio of 2.7:1. A total
of 72 patients (20%) were treated conservatively, 177 (49%) were treated with closed
management, and 109 (31%) with ORIF. The ORIF group demonstrated better outcomes than
the closed group in terms of reduced protrusive and lateral excursive movements, and
temporomandibular joint (TMJ) pain; and in terms of occlusal derangement when compared
with the conservative group. The ORIF group had poorer outcomes than both the closed
and conservative groups in terms of maximum mouth opening, and temporary facial nerve
injury occurred in 5/109 (5%) and condylar resorption in 2/109 (2%) of patients in
the ORIF group. There was no incidence of permanent facial nerve injury, Frey syndrome,
or paraesthesia of the auricular nerve. The trend that favours ORIF can be justified,
as it offers improved functional outcomes in severe or displaced condylar fractures.
However, this must be evaluated against the risk of potential surgical complications.
Careful case selection is therefore necessary to optimise management of these injuries.
Keywords
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Article info
Publication history
Published online: October 02, 2020
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© 2020 Published by Elsevier Ltd on behalf of The British Association of Oral and Maxillofacial Surgeons.
