Long-Term Clinical and Radiological Outcomes for the Surgical Treatment of Mandibular Condylar Fractures

Gerbino, Giovanni; Boffano, Paolo; Tosco, Paolo; Berrone, Sid

doi:10.1016/j.joms.2008.06.009

« Previous Next »Journal of Oral and Maxillofacial Surgery
Volume 67, Issue 5 , Pages 1009-1014, May 2009

Long-Term Clinical and Radiological Outcomes for the Surgical Treatment of Mandibular Condylar Fractures

Giovanni Gerbino, MD, DDS
- Assistant Professor, Division of Maxillofacial Surgery, Head and Neck Department, San Giovanni Battista Hospital, University of Turin, Turin, Italy
Paolo Boffano, MD
- Resident, Division of Maxillofacial Surgery, Head and Neck Department, San Giovanni Battista Hospital, University of Turin, Turin, Italy
- Address correspondence and reprint requests to Dr Boffano: Division of Maxillofacial Surgery, Head and Neck Department, University of Turin, Corso Dogliotti 14, 10126, Torino, Italy
Paolo Tosco, MD
- Resident, Division of Maxillofacial Surgery, Head and Neck Department, San Giovanni Battista Hospital, University of Turin, Turin, Italy
Sid Berrone, MD, DDS
- Professor and Director, Division of Maxillofacial Surgery, Head and Neck Department, San Giovanni Battista Hospital, University of Turin, Turin, Italy

Purpose

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.

Patients and 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.