Classification and Management of Mandibular Condyle Fractures in a Tertiary Health Center

Babatunde O Akinbami,Oladimeji A Akadiri

doi:10.4236/ss.2013.48067

Abstract

Background: Condyle fractures are not common but could lead to detrimental effects of growth disturbance of the mandible, ankylosis of temporomandibular joint and facial asymmetry especially in children, if not promptly and adequately managed, the aim of this study was to document our experience in the management of mandibular condyle fractures. Method: The fractures were classified based on the age of the patient, unilateral/bilateral, location on the condyle, presence of displacement and dislocation, for those displaced, whether there was medial or lateral overlap, and features presented. Treatment done for each patient was documented. Both clinical and radiological assessments were done to ascertain the outcome of treatment. Result: 11 patients presented with 14 condyle fractures, 3 patients with bilateral and 8 with unilateral condyle fractures out of which 5 cases were on the right side. Age range of patients was between 13 and 44 years with a mean (SD) of 25.3 (10.7) years. Nine (81.8%) of the patients were males and 2 (18.2%) were females. Eight (72.7%) of the patients with condyle fracture had associated fractures affecting other sites of the mandible while 3 (27.3%) patients had isolated condyle fractures. Intracapusular fractures recorded were 2 (14.2%), while extracapsular accounted for 12 (85.8%) cases. Conservative treatment was not applied in any patient, 9 (81.8%) patients had IMF and 2 (18.2%) patients had ORIF. Conclusion: Most fractures of the condyle were extracapsular and, closed surgical treatment (IMF) was very useful to manage most of the cases.

Highlights

Fractures of the condyle of the mandible are rare [1]
Despite the fact that the condyle is the weakest part of the mandible, fracture of this portion of the mandible from direct impact is not very common because of the protective and cushioning effects of the muscles, meniscus, ligament, capsule and surrounding bones [2]
There is no side predilection in condyle fractures as this is determined by the mechanics of injury, the position of patient and impact direction

Summary

Introduction

Condyle fracture is a protective mechanism which prevents fracture of the base of the skull [2] It is commonly an associated fracture with fractures of the body, symphysis or parasymphysis of the mandible due to transmission of forces following impacts on these sites. It can occur in isolation as a consequence of direct impact. These fractures have been classified as intracapsular or extracapsular, unilateral or bilateral and, head, neck (high or low) subcondylar fractures based on the site [3]. Conclusion: Most fractures of the condyle were extracapsular and, closed surgical treatment (IMF) was very useful to manage most of the cases

Objectives

Methods

Findings

Conclusion