Retrospective study for prognosis after open and closed reduction of the mandibular condyle fractures

Kim, Byoung Soo; Lee, Jae Hoon; Kim, Chul Hwan

Abstract

Condylar process of mandible, has the specialized anatomic structure compared with any other body structure, acts directly in connection with mastication and speech and so on. In general, mandibular condyle fractures have been managed by two methods as open and closed reduction. But, there are no reasonable consensus about the proper management of this injury. This study was designed for analysis of the prognosis of two methods of treatment, open and closed reduction, with positional change of fractured condyle and complications within 6 months post-intermaxillary fixation period. We conducted a retrospective analysis of 154 patients whose unilateral mandibular condyle fractures were treated by open or closed reduction in our department. The horizontal, sagittal, and coronal change of the condyle was examined using modified Towne's and panoramic radiographs before intermaxillary fixation(IMF), immediately after IMF, and at 6 months after IMF. Patients, whose mandibular condyle fractures were treated by closed reduction, had significantly shorter ramus height on the side of injury(P<0.05). But, fractured condylar fragments were displaced insignificantly with aspect to sagittal and coronal plane(P>0.05). The level of the fracture influenced the ramus length and the degree of coronal change in the closed reduction group(P<0.05). There was no significant correlation among the level of the fracture, treatment methods and complications(P>0.05). From the results obtained in this study, fractured mandibular condyles, were treated by closed reduction, had a tendency that continuous condylar displacement was occurred with aspect to horozontal and coronal plane in treatment period including intermaxillary fixation. And then there was a correlation between the level of the fracture and the position change in close reduction group statistically. These result suggested that care must be taken in basing treatment decisions on the degree of displacement of the condyle and in treating the mandibular condyle fractures for a long time.