Long-term outcomes after treatment of condylar fracture by intraoral access: a functional and radiologic assessment.
OBJECTIVE
The aim of the present study was to investigate radiographic and functional long-term results after condylar fractures have been reduced by an exclusively intraoral surgical approach.


METHODS
A total of 25 (21 male, 4 female) consecutive patients with 30 condylar process fractures were retrospectively investigated. Clinical follow-up was performed in 19 patients (16 male, 3 female) with a total of 24 fractures. Median postoperative follow-up time was 19.7 months. Surgical indications followed specific parameters of fracture localization, dislocation, and ramus shortening. All patients were examined in accordance with the Research Diagnostic Criteria for Temporomandibular Dysfunction (RDC/TMD) and the Helkimo Index. Orthopantomograms (OPGs) were analyzed with use of the condylar morphologic scale (CMS), and mandibular ramus position and height were measured.


RESULTS
Fractures were classified as condylar neck (n = 2) and basis fractures (n = 28), according to criteria of the Strasbourg Osteosynthesis Research Group (SORG). Mean age of patients was 33 years (standard deviation [SD], 13 yr). RDC/TMD measurements at follow-up showed a mean mouth opening of 48 mm (SD, 9), mandibular laterotrusion right of 11 mm (SD, 3.8), laterotrusion left of 10 mm (SD, 4.5), and protrusion with a mean of 5.83 mm (SD, 3). No joint clicking, weakness of the facial nerve, or joint or muscular pain was observed. Statistical analysis of the CMS showed significantly better postoperative ramus height (P < .05).


CONCLUSIONS
Reduction achieved by this technique allows reconstruction of anatomic ramus height in combination with excellent functional results.
Veras
Rafael Block
RB
Department of Oral and Plastic Maxillofacial Surgery, Martin Luther University Halle-Wittenberg, Halle, Germany. rafaelblockveras@gmail.com
Kriwalsky
Marcus S
MS
Eckert
Alexander W
AW
Schubert
Johannes
J
Maurer
Peter
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D004724:Endoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008297:Male; D008335:Mandibular Condyle / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D008337:Mandibular Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D019647:Oral Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D019637:Orthopedic Procedures / Q000295:instrumentation / Q000379:methods; D011859:Radiography; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods*; D020127:Recovery of Function; D016896:Treatment Outcome