[Orthopaedic treatment of extraarticular condylar fractures of the mandible: retrospective study of 39 unilateral cases]

Abstract

Introduction: Although for an increasing number of authors open reduction and internal fixation (ORIF) is becoming the standard of care for mandibular subcondylar fractures, functional treatment is still performed worldwide. The aim of this study was to evaluate the results of functional treatment in isolated mandibular subcondylar fractures.

Material and methods: Patients presenting with an isolated low subcondylar fracture between 1998 and 2004 were enrolled in a retrospective study. We focused on the epidemiology, type of fracture, degree of displacement, treatment protocol and short-term outcome. Patients were interviewed to evaluate long-term results.

Results: Thirty-nine patients were enrolled in this retrospective study. The mean displacement was 15 degrees of medial angulation and a shortening of the ramus ranging around 5mm. Thirty-one patients recovered normal mandibular function (mouth opening more than 45 mm, with no or minimal deviation). Sixteen presented with TMJ disorders, deemed minor by the patients themselves. None of them required any specific treatment. Eighteen had posttraumatic occlusal discomfort corrected by dentistry or prosthetic adaptation. Long-term follow-up X-rays showed minor residual condylar displacement. In all cases, patients estimated their treatment acceptable.

Discussion: The orthopedic treatment of low subcondylar fractures provides acceptable functional results. This technique is simple, safe and remains a valuable therapeutic option. In the future, experience with surgical management will probably lead to specific indications of both closed and open methods.