Management of bilateral condylar fractures: Case review

Abstract

Unilateral mandibular condylar fractures occur approximately three times more frequently than bilateral fractures [1]. Fracture of the mandibular parasymphysis region is usually associated with fracture of contralateral condyle. Unilateral fracture condyle may occur as an isolated case or along with fracture of mandible or other facial bones. Unilateral condylar fractures without displacement, are generally treated conservatively using arch bars and intermaxillary fixation (IMF). It is rare to see bilateral fracture condyle without any other associated fracture. Deranged occlusion, inability to masticate food, difficulty in opening mouth, haemotympanum and pain in preauricular region are some of the complaints of patients. In bilateral subcondylar fractures the dilemma remains whether to manage it conservatively, perform open reduction and bone plating of one side only or perform open reduction and bone plating of bilateral condyles. The age of the patient, the level of fracture, angle of displacement, dislocation of condylar head and presence of other associated fractures influences a surgeon's decision. The growth of the mandible continues throughout childhood and adolescence. So in children, IMF is restricted to fourteen days to facilitate early movement and to prevent ankylosis of temporomandibular joint (TMJ). Four cases of bilateral condylar fractures are being reviewed.