Mandibular condyle fractures: determinants of treatment and outcome.
OBJECTIVE
The objective of this study was to analyze the principal variables that determine the choice of the method of treatment and the outcome in condylar fractures.


METHODS
We conducted a retrospective analysis of 104 mandibular condyle fractures to analyze and determine the relation between the principal clinical variables and the postoperative results. All patients underwent a clinic-radiologic investigation focusing on fracture remodeling, evolution, dental occlusion, and symmetry of the mandible. We analyzed the influence of the preoperative clinical variables (level of fracture, treatment, postoperative physical therapy, displacement and dislocation, comminution, loss of ramus height, patient age, gender, etiology, occlusion, status of dentition, and presence of facial and mandibular fractures) over the postoperative results and outcome.


RESULTS
The principal factors that determined the treatment decision were the level of the fracture and the degree of displacement. The level of the fracture influenced the degree of preoperative coronal and sagittal displacement (neck fractures had greater medial and anterior displacement than head and subcondylar fractures) and the treatment applied. The functional improvement obtained by open methods was greater than that obtained by closed treatment. Open treatment increased the incidence of postoperative condylar deformities and mandibular asymmetry.


CONCLUSIONS
The variables that influenced the method of treatment and predicted the prognosis are the level of fracture, degree and direction of displacement of the fractured segments, age, medical status of the patient, concomitant injuries, and status of dentition.
Villarreal
Pedro M
PM
Department of Oral and Macillofacial Surgery, Hospital de Calbueñes, Gijón, Spain. pedrovillarreal@eresmas.com
Monje
Florencio
F
Junquera
Luis M
LM
Mateo
Jesús
J
Morillo
Antonio J
AJ
González
Cristina
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003657:Decision Making; D005260:Female; D005592:Fracture Fixation / Q000379:methods*; D006801:Humans; D004204:Joint Dislocations / Q000145:classification / Q000628:therapy; D008297:Male; D008335:Mandibular Condyle / Q000293:injuries* / Q000601:surgery; D008337:Mandibular Fractures / Q000145:classification / Q000628:therapy*; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D012189:Retrospective Studies; D013704:Temporomandibular Joint / Q000293:injuries* / Q000601:surgery; D016896:Treatment Outcome