Factors affecting the outcomes of non-surgical treatment of intracapsular condylar fractures

Abstract

Abstract: PURPOSE: To investigate the factors affecting non-surgical treatment of intracapsular condylar fractures (ICFs) and to provide scientific basis for the treatment of ICFs. METHODS: Patients with ICFs who received non-surgical treatment at the Department of Oral Surgery, Shanghai Ninth People's Hospital between January 2003 and July 2014 were recruited. Coronal computed tomography (CT) images of these patients were taken and evaluated after injury and at least 3 months later during follow-up visits. Fracture healing was classified into 4 grades. SPSS 18.0 software package was used for statistical analysis and comparing the factors that affected fracture healing, including gender, age, fracture type and relative position of the mandibular ramus stump and the articular fossa. RESULTS: A total of 106 cases (145 sides) of ICFs with non-surgical treatment were collected. Thirty-one sides (21.4%) achieved grade 1 healing, 66 sides (45.5%) exhibited grade 2 healing, 43 sides (29.7%) exhibited grade 3 healing, and 5 sides (3.4%) exhibited grade 4 healing. A significant difference was observed in the fracture-healing grade among 3 factors: age, fracture type, and relative position of the mandibular ramus stump and the articular fossa. Gender was not a significant factor regarding to fracture healing. CONCLUSION: Age, fracture type and relative position of the mandibular ramus stump and the articular fossa were important factors for healing of ICFs treated non-surgically. The younger the patient, the better the healing and remodeling of the fracture. Comminuted fractures in general showed a poor prognosis. An unfavourable prognosis was also observed in cases in whom the mandibular ramus stump contacted the bottom of the articular fossa or in cases with superolateral dislocation of the joint, both of which easily led to ankylosis.

Key words: Temporomandibular joint, Condylar fractures, Intracapsular fractures

CLC Number:

R782.4

WANG Bao-li, HE Dong-mei, YANG Chi, CAI Yi-hua, CAI Xie-yi, YANG Xiu-juan, MA Zhi-gui. Factors affecting the outcomes of non-surgical treatment of intracapsular condylar fractures[J]. China Journal of Oral and Maxillofacial Surgery, 2016, 14(3): 228-233.

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