Functional Outcomes of Surgical Management of Mandibular Condylar Head Fractures

Background Various procedures have been described for the management of mandibular condylar head fracture, but a standard treatment is not yet conclusive. This report describes our experience with osteosynthesis of condylar head fracture at Linkou Chang Gung Memorial Hospital. Methods Sixteen patients with unilateral or bilateral mandibular condylar head fractures diagnosed by computed tomography and treated by open reduction and internal fixation between August 2014 and September 2016 were retrospectively reviewed. A preauricular approach was consistently used for internal fixation with 2 microplates and 4 screws after anatomic reduction. Occlusion, maximum mouth opening (MMO), radiographic outcome, and complications were recorded. Results Mean +/- SD patient age was 29.5 +/- 11.4 years, and mean +/- SD procedure time was 264.3 +/- 83.1 minutes. Mean +/- SD postoperative MMO was 23.5 +/- 10.2 mm at 1 month, 34.1 +/- 8.6 mm at 3 months, 39.1 +/- 5.7 mm at 6 months, and 40.0 +/- 6.8 at 1 year. Early recovery of MMO of greater than 30 mm was achieved by 13 patients at 3 months after open reduction and internal fixation. There were no major complications. Conclusions Microplate fixation from the posterior aspect of the mandibular condylar head via the preauricular approach was safe for patients with mandibular condylar head fractures.