Bilateral Condylar Head Fractures Research Articles

Functional and Occlusal Discrepancy in Mandibular Condyle Fractures Treated with Closed Reduction and Immobilization

Background: Condylar fractures, a common type of mandibular fractures, require meticulous consideration in selecting the appropriate treatment approach. Among the available choices, conservative management has proven to be a valuable strategy for specific cases. Objective: To ascertain the frequency of postoperative functional and occlusal discrepancies in condylar fracture patients managed conservatively. Materials and Methods: This descriptive cross-sectional study involved 183 patients, in accordance with our designated sample size. Diagnosis of condylar fractures was confirmed through radiographs, including orthopantomograms and posterior-anterior views. Reduction and immobilization were performed using eyelet loop wiring for 3 to 4 weeks. Clinical assessment of malocclusion and mouth opening was conducted post-immobilization, with mouth opening measured as interincisal distance using a ruler. Chi-square tests were conducted to assess the association of mouth opening and malocclusion with age, gender, and fracture type. Results: The mean age was 44 years ± 10.37, and the average mouth opening measured 35 ± 2.12 mm. Gender-wise, 38 (20.76%) patients were identified as female, while 145 (79.23%) were male. Regarding the type of condylar fracture, 148 (80.87%) patients had unilateral fractures, and 35 (19.12%) exhibited bilateral fractures. No significant associations were observed between mouth opening and malocclusion with age, gender, or fracture type. Conclusion: Conservative management through closed reduction and immobilization for unilateral and bilateral condylar head fractures yields superior functional and radiographic outcomes. Keywords: Bilateral condylar fractures, Malocclusion, Unilateral condylar fractures.

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

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.

Delayed open reduction and single screw internal fixation as a treatment option in case of failed nonsurgical treatment of bilateral condylar head fractures with fragmentation

Delayed open reduction and single screw internal fixation as a treatment option in case of failed nonsurgical treatment of bilateral condylar head fractures with fragmentation

Delayed open reduction and single screw internal fixation as a treatment option in cases of failed non-surgical treatment of bilateral condylar head fractures with fragmentation

To share our experience in the open reduction and single screw internal fixation of delayed bilateral condylar head fractures with fragmentation and evaluate its feasibility and outcomes. The study involved 6 males and 1 female. All patients had multiple injuries at different body sites and failed non-surgical treatment of bilateral condylar head fractures. The mean period between the injury and the operation was 5.7 (4-8) weeks. According to the preoperative computer-aided design, and the clinical manifestations, the fracture fragments were reduced and fixed with a single screw. A helical CT scan was requested postoperatively to check the reduction of the fragments and the location of the screws. Mean follow-up duration was 9.7 (8-14) months. The malocclusion was corrected after operation. The intraoperative passive mouth opening was 3.93±0.19cm. The mouth opening was 3.43±0.35cm in 3 months follow-up, and more than 3 transverse fingers at the last follow up. No one had a progressive limitation of the mouth opening in 8-14 months of follow up. The strategy of open reduction and single screw internal fixation of bilateral condylar head fracture with fragmentation of mandible is feasible and effective. It is a treatment option in the rare delayed cases of failed non-surgical treatment.