Open reduction of condylar fractures—A right treatment perspective?

Abstract

The aim of this study was to evaluate the outcome of open reduction of condylar fractures. Seventy-three patients having 84 condylar fractures of various types operated by a single surgeon between 1991 and 2007 were analysed retrospectively. Rigid fixation was done in 70 cases by using plates and screws whilst condylectomy was done in 14 cases. Explorations were done either by an extended Risdons or by preauricular approach. No immobilisation was done. Results were analysed immediately, after 3 months and over long-term with respect to occlusal status, mouth opening and deviation, TMJ pain, facial nerve function and chewing efficiency. Suitability of approach with respect to access, ease, safety, duration and aesthetics was also analysed. In no case, malocclusion was noted. Facial paralysis occurred in one case (1.2%). Temporary Temporal branch weakness associated with preauricular approach was seen in 20 cases (34.4%), while Mandibular branch weakness associated with the extended Risdons approach was seen in eight cases (30%). Two wounds (2.4%) got infected requiring plate removal. Mouth opening and chewing efficiency could be restored to normal within 3 months. No TMJ pain noted after 3 months. No case showed healing problem. Preauricular approach was superior to extended Risdons approach. Considering the outcome, extra oral open reduction should be the treatment of choice in the management of condylar fractures.