Quantitative Assessment of Condylar Remodeling After Open Reduction and Internal Fixation in Mandibular Condylar Head Fractures

Abstract

Open reduction and internal fixation (OR/IF) and closed treatments are viable options, with OR/IF gaining popularity in mandibular condylar head fracture (CHF). Sufficient research is lacking on long-term condylar morphologic changes. This study quantitatively evaluated the morphologic changes in the condylar head in patients who underwent OR/IF for CHF without the removal of osteosynthesis material. A retrospective study analyzed patients who underwent OR/IF for CHF between November 2010 and August 2022. The transverse/lateral condyle width and condyle height were radiologically analyzed using panoramic and reverse Towne view x-ray images at immediate (T0), short-term (T1), and long-term (T2) postoperative periods. The study involved 29 patients with 32 surgically treated CHF. Long-term condyle height decreased significantly from 18.9±0.8 mm at T0 to 18.1±0.8 mm at T1 (P=0.042), and further to 17.3±0.7 mm at T2 (P=0.034). Transverse width slightly reduced from 18.7±0.7 mm at T0 to 17.9±0.8 mm at T1 (P=0.001) but remained stable from T1 to T2 (17.6±1.0 mm, P=0.756). Following surgery, maximal mouth opening averaged 39.5±6.1 mm, with one case of chin deviation and three cases of joint pain. The condyle undergoes long-term shortening without altering its width. Nevertheless, patients experience favorable functional outcomes, including satisfactory mouth opening and occlusion. In addition, it is advisable not to remove the osteosynthesis material, as the remaining material causes minimal functional impairment and bone resorption.