Surgical Reduction of Symphysis Fracture and Spontaneous Repositioning of the Mandibular Condyle: A Case Report

Abstract

The condylar process is a more fragile area, which is usually fractured by indirect trauma. The objective of this study is to report the case of a 10-year-old patient who presented to the Maxillofacial Surgery and Traumatology Service of the Regional Hospital of Vale do Paraíba, in Taubaté-SP, Brazil. Physical examination revealed limited mandibular movement with painful symptoms, crossbite, and upper incisor avulsion. A face tomography showed a fracture of the mandibular symphysis (right side) and a fracture of the left condyle. Surgical reduction of the mandibular symphysis fracture was performed. After exposure and reduction of bone segments, maxillomandibular block, rigid internal fixation and conservative treatment for condyle fracture were performed. A soft liquid diet and weekly outpatient follow-up was adopted for the first two months. After 15 days of surgery, the patient had mild edema, slight limitation in mouth opening, sutures without dehiscence and without signs of infection. In the first control tomography, the treated fracture was adequately reduced and the fractured condyle remained with medial displacement in the glenoid cavity. After one year, on physical examination, the patient presented satisfactory dental occlusion, preserved mandibular movements and no signs of nerve damage. The tomography showed the fracture consolidated, and the left mandibular condyle well positioned in the glenoid cavity. After two years, the third tomography was performed, showing remodelling of the left mandibular condyle.