Factor of Long Term Outcome in Closed Reduction of Condylar Fracture of the Mandible: A Prospective Study

1 Division of Plastic and Reconstructive Surgery, Department of Surgery, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand

Affiliation : Chairat Burusapat MD, FRCST1

Background : Condylar fractures of the mandible are one of the most common facial fractures, however, methods of treatment remain controversial. Closed reduction is the alternative method but long-term outcome has never been established.
Materials and Methods : A prospective study of condylar fractures of the mandible in Phramongkutklao Hospital between January 2010 and December 2014 was conducted. Clinical and radiologic examinations were recorded. All patients were followed up at 3, 6, and 12 months for complete protocol.
Results : Thirty-two patients that presented pure condylar fractures were included in the present study. Thirty-(cid:976)ive fracture sites of the condyle were analyzed from 29 and three patients in unilateral and bilateral fracture, respectively. Average time for maxillomandibular (cid:976)ixation [MMF] was 20.4 days (14 to 28 days). Condylar neck and slightly displaced were the most common types of fracture. The occlusion was returned to pre-injury 86.21% in unilateral and 66.67% in bilateral fractures. Six and one patients in unilateral and bilateral fractures had pain when chewing, respectively. The clicking sound of TMJ was found among eight patients presenting unilateral and one patient presenting bilateral fracture. Deviation of mandible during open mouth was found in 21 patients of unilateral and one patient of bilateral fracture. Mean deviation of the mandible was 2.35 mm (1 to 4 mm). Means of interincisal distance was 35mm (30 to 42 mm). No statistical signi(cid:976)icance was found between malocclusion, pain on chewing on each site and type of fracture for both unilateral and bilateral condylar fractures. Statistical signi(cid:976)icance was found between clicking sound and fractures site in unilateral condylar fractures.
Conclusion : Closed reduction of condylar fracture in unilateral fracture has favorable long-term outcome. The predictive factor of malocclusion is dislocated subcondylar bilateral fractures of condyle. The predictive factor of clicking sound is unilateral fracture head of condyle.

Keywords : Condylar fracture of the mandible, Closed reduction, Outcome

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