Exclusive functional treatment for mandibular condylar fractures

Abstract Introduction Despite the frequency of condylar fractures, there is no concensus regarding treatment alternatives, e.g operative or non-operative. The purpose of this study was to describe functional treatment without intermaxillary fixation of condylar fractures and summarize treatment outcomes. Materials and methods The investigators designed a retrospective case series, and enrolled a sample composed of patients with condylar fractures with malocclusion. The primary outcome was treatment success assessed at the end of six weeks. The authors recorded five parameters to assess treatment success: stable return to the initial occlusion, lateral excursion of more than 7 mm, centered protrusion of more than 4 mm, centered mouth opening of more than 35 mm, painless mandibular mobilization. If all five parameters are met, treatment is deemed a success. Treatment failure is defined as meeting less than all five parameters. We used numbers and percentages for these nominal qualitative variables (healing criterion absent or present). Two prognostic variables, i.e., fracture type and age range, according to treatment success, were compared using Fisher’s test for patients presenting all healing criteria. Results Thirty patients with a median age of 33 were included. There were 15 low sub-condylar fractures (44.1%), 12 high sub-condylar fractures (35.3%), and 7 head condylar fractures (20.5%). On the last consultation, 21 (70%) patients exhibited all criteria defining treatment success. There was a significant difference in the success rate according to age (p = 0.002) in favor of the younger patients. High sub-condylar and head fractures were associated with a better success rate. Conclusion Exclusive functional treatment showed promising results and should be considered for cooperative patients, avoiding risks of surgery or discomfort in intermaxillary fixation.