Comparative Study between IMF and Pure Conservation in Management of Condylar Head Fracture in Children

Abstract

Background: The purpose of the present study was to compare IMF and pure conservation in management of condylar head fracture in children treated at the Department of Maxillofacial Surgery, Faculty of Medicine, Assiut University, Egypt, between 2011G - 2016G. Methods: Twenty four patients with condylar head fractures were included in this study, 14 males and 10 females ranging in ages from 5 – 15 years. They were divided into two equal groups. In group 1, twelve patients were treated by closed reduction for 2-3 weeks followed by physiotherapy, while group 2 patients were managed by pure conservation only for the same period. Outcome results on clinical and radiological parameters were evaluated during the follow up period. Results: In group 1, the maximum mouth opening after 2 months was ranged from 28-36 mm (average 32mm),while signs of development of ankylosis were reported in 3 patients. In group 2, the maximum interincisal opening was ranged from 28-37 mm (average 32.5mm) with absence of ankylosis. Pain in TMJ was noted in 3 cases of bilateral condylar head fractures of this group, but subsided gradually on the follow up. Conclusions: This study concluded that treatment of patients by closed reduction give satisfactory clinical results, though the condyle is not anatomically normal in radiographs. Whereas management of patients by pure conservation only without any surgical intervention showed excellent results clinically as well as radiographically. Perhaps a study conducted on larger number of patients with longer post operative follow up will throw more light on this subject.