Long-term clinical and radiological outcomes for the surgical treatment of mandibular condylar fractures.
OBJECTIVE
This retrospective study evaluated the long-term results and complications of open reduction and internal fixation of displaced and dislocated fractures of the condylar process.


METHODS
Two hundred four patients were treated via various surgical approaches between 1991 and 2005. Fifty patients with a total of 57 treated condylar fractures who underwent complete clinical and radiological documentation were included in this study. Follow-up clinical and radiological evaluations were carried out after an average period of 88 months.


RESULTS
We found that 12% of our patients reported temporary weakness of the facial nerve and 4% had mild permanent facial nerve palsy. Clinical and radiological assessment showed satisfactory recovery of facial symmetry. Excellent recovery of function was observed, and very few patients complained of temporomandibular joint-related symptoms. Severe condylar remodeling was observed in 8% of the patients, 47% showed slight or moderate remodeling, and 45% showed no remodeling. A statistically significant association was observed between the presence of condylar remodeling and poor mouth opening at the follow-up examination.


CONCLUSIONS
Surgical treatment of condylar fractures, in association with postoperative functional therapy, promotes the recovery of function, occlusion, and facial symmetry with few complications. However, some difficulties remain related to the surgeon, the patient, and the objective complexity of this pathology.
Division of Maxillofacial Surgery, Head and Neck Department, San Giovanni Battista Hospital, University of Turin, Turin, Italy.
Giovanni
G
Gerbino
Paolo
P
Boffano
Paolo
P
Tosco
Sid
S
Berrone
D000293:Adolescent; D000328:Adult; D005158:Facial Paralysis / Q000209:etiology; D005260:Female; D005593:Fracture Fixation, Internal; 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 / Q000009:adverse effects; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011859:Radiography; D016896:Treatment Outcome; D055815:Young Adult