Sagittal fracture of mandibular condyle: a review of 151 cases

Abstract

Objective: A retrospective research was made to summarize the clinical characteristics, treatment methods, results of the adult cases with sagittal fracture of mandibular condyle (SFMC). Methods: One hundred and fifty-one cases of hospitalized patients were enrolled. The age, sex, etiology, level of fracture, degree of displacement, associated facial fractures, treatment methods and results were retrospectively analyzed. Results: The patient's age ranged from 16 to 81 years old, with a median age of 38.5 years. The male to female ratio was 2.97∶1. The most involved age group was 20-29 years old [35.1% (53/151)]. Falls [53.6% (81/151)] were the most common cause. According to the classification of He (2009) and Duan (2011), the most common type of SFMC was type A [60.5% (130/215)] and the displacement type [80.9% (174/215)]. Eighty-six point zero percent (185/215) of SFMC were treated by surgery. The surgical rates of type A, B and M fractures were 91.5% (119/130), 79.6% (43/54) and 88.5% (23/26), with significant differences between the groups (P<0.05). The surgical rates of the displacement and dislocation type were 89.7% and 100%, with significant differences. The differences between the fixations of type A, type B and type M fractures were statistically significant. The follow-up results showed that, 78.7% (59/75) of patients treated with surgery had normal occlusion, no joint symptoms and no limited mandibular movement. Patients treated with conservative therapy had good occlusion and an average maximum mouth opening of 36.25 mm with malunion occurred in 5/6 of the condyles. Conclusions: Under appropriate surgical indications, surgical treatment of SFMCs could achieve significantly better outcomes than conservative treatment.