Assessment of patients treated for intracapsular fractures of the mandibular condyle by closed techniques.
OBJECTIVE
The goals to study different lines of intracapsular fractures of the mandibular condyle and to evaluate their influence on the prognosis after closed treatment.


METHODS
Clinical, radiologic, and axiographic follow-up of 40 patients with 50 intracapsular fractures of the mandibular condyle was carried out after closed treatment. The examinations were performed an average of 22 weeks after treatment. Three types of intracapsular fractures were distinguished: type A, or fractures through the medial condylar pole; type B, or fractures through the lateral condylar pole with loss of vertical height of mandibular ramus, and type M, multiple fragments, comminuted fractures.


RESULTS
Moderate to serious dysfunction was observed in 33% of the cases. Radiologic examination of fracture types B and M revealed a reduction in the height of the mandibular ramus of up to 13% compared with the contralateral side. These 2 fracture types also resulted in the most prominent deformations of the condylar head. Axiography revealed irregular excursions and a limitation of condylar movement in comminuted fractures of up to 74% compared with the nonfractured side.


CONCLUSIONS
Lesions to the osseodiscoligamentous complex of the temporomandibular joint caused by intracapsular fractures of the mandibular condyle can be severe. The poor functional and radiologic results encountered in the fracture types B and M showed the limitations of closed functional treatment.
Hlawitschka
Matthias
M
Department of Oral and Maxillofacial Surgery, Technical University of Dresden, Fletcherstrasse 74, D-01307 Dresden, Germany.
Eckelt
Uwe
U
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005157:Facial Pain / Q000145:classification; D005260:Female; D005500:Follow-Up Studies; D018460:Fractures, Comminuted / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007103:Immobilization; D019248:Jaw Fixation Techniques; D007574:Jaw Relation Record; D008297:Male; D008310:Malocclusion / Q000145:classification; D008335:Mandibular Condyle / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D008337:Mandibular Fractures / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D009068:Movement; D017289:Orthodontic Appliances, Functional; D011379:Prognosis; D011862:Radiography, Panoramic; D016059:Range of Motion, Articular / Q000502:physiology; D013223:Statistics as Topic; D013704:Temporomandibular Joint / Q000293:injuries; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome