Can Condylar Fracture Still Be Treated with Conservative Approach?? – A Retrospective Study

Abstract

Background: Ideal management of mandibular condylar fractures remains controversial in maxillofacial trauma. Traditionally, conservative approach was implemented but recently ORIF (Open Reduction with Internal Fixation) has become prevalent. A difference of opinion has been acknowledged in the review of literature concerning the results achieved by open/closed reduction of fractures of the condyle in mandible. Research Objectives: To assess the preference of treatment for fractures of condyle and their indications, advantages, disadvantages and complications for open/closed reduction of fractures of condyle. Methodology: A 13-year retrospective study involving 56 patients who reported with fractures of condylar region were selected from 264 patients who experienced maxillofacial fractures. Out of them, seven were treated with ORIF, while 49 underwent closed reduction. Every patient was critically evaluated for identifying their indications, advantages, disadvantages, their effectiveness and complications of chosen interventions used in the management of condylar fractures. Findings: A male predominance was observed. Closed reduction with concomitant active physical therapy after inter-maxillary fixation gave similar results to that of open method. Conclusion: This study manifested that an appropriately followed conservative treatment provided similar clinical results when compared to ORIF for the management of condylar fractures. In cases with severe loss of height of mandible, surgical intervention is to be preferred to restore it. Further prospective randomized controlled trials with larger sample size are required to come to a decisive conclusion.