• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.25 no.2
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• pp.447-457
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• 1995

The subjects of this study consisted of 75 patients with 83 condylar fractures, who were admitted to Chonbuk National University Hospital from Jan. 1988 to Oct. 1995. The purpose of this study was to compare the imagings of conventional radiograms with those of computed tomograms and to aid in the diagnosis of condylar fractures. Also the author evaluated the usefulness of 3-dimensional reconstructive imaging in condylar fractures. The obtained results were as follows: 1. The condylar fractures were observed mainly between 2nd and 4th decades, but there was no significant difference of incidence between decades. The incidence of condyalr fractures by fracture site was subcondyalr(44.6％), condylar head(36.1％), condylar neck(19.3％) in orders. 12 of 30 condylar head fractures were sagittal splitting fractures. 2. According to the relationship of condylar head to articular fossa, the incidence of condylar fractures was higher in Type II and Type m. And the incidence of subcondylar fractures was higher in Type I classified by Mclennan. But there was no significant difference of incidence between Types. 3. The more the fracture fragments were displaced, the easier the fracture patterns were detected in conventional radiograms. The computed tomograms were also useful in the diagnosis of sagittal splitting fractures which were displaced mesially. 4. The 3-dimensional reconstructive imaging were useful in the evaluation of the fracture patterns, but they were not useful when the size of fragment and the degree of displacement were small.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.6
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• pp.448-456
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• 2011

Introduction: Condylar fractures are common in the maxillofacial region, comprising 29-40 percent of all mandibular fractures, accounting for about 20-62 percent). Previous studies reported that pediatric condylar fractures can cause disorders in facial growth and function, and the treatment methods have been controversial. Recently, conservative treatment has shown good results in skeletal growth and functional recovery but the conservative treatment of pediatric condylar fractures has shown unpredictable and undesirable results in some cases, such as facial asymmetry and temporomandibular joint disorder. This study examined the specific age groups and specific mandibular condylar fracture type in growing children treated conservatively in the past. Materials and Methods: Eighteen patients (10 men and 8 women) who received conservative treatment for unilateral condylar fractures in Dankook University Dental Hospital between 2000 to 2007 were followed up for a mean period of 7.2 years. Results: In the survey of 18 pediatric patients who received conservative treatment for condylar fractures, the incidence of temporomandibular dysfunction and growth disturbance was 45% and 35%, respectively. Conclusion: In all complications, the symptoms observed most frequently was mouth opening displacement of the mandible exceeding 2 mm. The other complications of functional and growth disturbance included facial asymmetry concentrated along specific condylar types. Complications including facial asymmetry and functional and growth disturbances showed an increasing tendency according to the specific fracture types. Functional and growth disturbances in the undisplaced condylar fracture type showed a lower incidence(P <0.05). Functional and growth disturbances differed according to the fracture type, which has poor relationship with articular fossa and condyle(P <0.05). Functional and growth disturbance in the cases of the high-level condylar fracture type showed a higher incidence(P <0.05). The functional and growth disturbances of the fracture types were similar in the fragment-contact and non-contact groups(P >0.05).

• Maxillofacial Plastic and Reconstructive Surgery
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• v.14 no.4
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• pp.295-304
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• 1992

The author investigated the 162 patients with the condylar fractres of the mandible who were admitted in Dept. of Oral and Maxillofacial Surgery, Hospital of Chosun Dental School from January 1985 to September 1992 clinically, including fracture incidennce, age and sex of the patients, causes of injures, associated injures, treatments and complications and obtained the following results. 1. Of the 449 patients with mandibular fractures, 162patients suffered condylar fractures(36.1%). 2. Of the 162 patients, males with condylar fractures were 128 patients, by a ratio of 3.8 : 1. 3. The most frequently affected age group was the third decade(32.7%). 4. Falls were ranked as the predominant cause(50.6%), followed by traffic accident(27.8%) and violence (16.0%). 5. The incidence of single condylar fractures was 28% and symphysis fractures were the most commomest of the concomittant injuries(60%). 6. The subcondylar fractures occurred most frequently(41.6%) and anteromedial displacement of the condylar fragments occurred most frequently(45.4%) 7. Of the all condylar fracture patients, children under 15 of age comprized 31 patients(19.1%) and condylar head fractures occurred most frequently at those children. 8. Of the managetments in condylar fractures, open reduction was 52.5% and remainder were closed reduction(47.5%). 9. Complications ensured such as TMJ ankylosis, limitation of mouth opening and mandibular movements, TMJ dysfunction, and anterior open bite.

• Archives of Plastic Surgery
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• v.45 no.1
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• pp.23-28
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• 2018

Background Condylar process fractures account for one-third of all mandibular fractures, and the distal fragment is prone to dislocate to the medial side due to the pulling of the lateral pterygoid muscle. Retromandibular approaches are commonly used, but the intraoperative view becomes limited in medially dislocated fractures. This study summarized a series of cases of retromandibular reduction for medially dislocated condylar process fractures and described our supplementary procedure to realign the dislocated condylar process. Methods Nine patients with medially dislocated condylar process fractures underwent surgical correction from January 2012 to December 2016. In 6 of them, it was possible to realign the fractures with a conventional retromandibular approach, but for 3 cases of severe dislocation to the middle cranial fossa, a supplementary transoral procedure was carried out. The angle difference between the ramus and condyle, ramus height, and maximal mouth opening (MMO) were evaluated. Results All 9 cases were restored to the proper anatomical alignment without any major complications, and postoperative images revealed successful union. The angle difference was $8.94^{\circ}{\pm}4.11^{\circ}$ preoperatively, and $0.99{\pm}0.49^{\circ}$ at the 6-month follow-up. The pretreatment ramus height difference was $6.12{\pm}6.09mm$, and the postoperative difference was $0.18{\pm}0.10mm$. These changes after surgery were statistically significant. The MMO before surgery was $11.44{\pm}3.0mm$, and the postoperative MMO was $37.2{\pm}2.9mm$, reflecting a significant increase after reduction. Conclusions Retromandibular reduction is a useful method in medially dislocated condylar process fractures, and additional transoral assistance should be considered to realign condylar processes that severely dislocate to the middle cranial fossa.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.5
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• pp.267-276
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• 2022

Objectives: Recently a modified high-submandibular approach (HSMA) has been introduced for treatment of condylar fracture. This approach involves an incision line close to the mandibular angle and transmasseteric transection, leading to a low incidence of facial palsy and allowing good visualization of the condyle area, especially the condylar neck and subcondyle positions. This study reports several cases managed with this modified HSMA technique for treating condylar fractures. Materials and Methods: Six cases of condylar fractures treated with modified HSMA technique were reviewed. Results: Three unilateral subcondylar fracture, 1 bilateral subcondylar fracture, 1 unilateral condylar neck fracture, 1 unlateral simultaneous condylar neck and subcondylar fracture cases were reviewed. All the cases were successfully treated without any major complication. Conclusion: Reduction, fixation, and osteosynthesis of condylar fractures via the modified HSMA technique enabled effective and stable treatment outcomes. Therefore, the described approach can be used especially for subcondylar and condylar neck fractures with minimal complications.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.4
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• pp.359-369
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• 2008

Purpose: Fractures of the mandibular condyle accounts for 15% to 30% of all the mandibular fractures and lots of complications are reported. Among these complications, condylar resorption is the most important one to be taken into account. The purpose of this study is evaluating condylar resorption pattern in relation to extracorporeal fixation technique. Patients & methods: Thirty four patients with 42 mandibular condylar fractures were retrospectively examined with an average follow-up of 18.5 months (6-66 months). Male/female ratio is 27 males (7 bilateral cases) and 7 females (1 bilateral case). Applicated surgical techniques were extracorporeal fixation via submandibular approach and extracorporeal fixation via intraoral approach. We compared radiographic views of post-operative periods with that of most long term follow up in 34 operated sites respectively. Result: There were 2 generalized condylar resorption sites and 3 partial resorption sites with clinical implications. Others (29 joints) showed good healing or satisfactory adaptive state of temporomandibular joints clinically. Radiologically, signs of partial condylar resorption and/or osteoarthrosis were diagnosed in 11 patients. But, 8 out of the 11 patients didn't show significant clinical symptoms, which means successful adaptive remodeling of the surgically located condylar head. Conclusion: From the above results, intentional ramal osteotomy, temporary detachment of the fractured condyle and extracorporeal fixation technique seems to be effective and useful in those cases of condylar fractures in which reduction of the dislocated condyle is very difficult or virtually impossible.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.6
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• pp.535-544
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• 2005

The management of mandibular condyle fractures continues to be a subject of much debate. It is suggested that, if not properly managed, these fractures may give rise to serious problems, such as malocclusion, mouth opening limitation, temporomandibular joint disorders. Treatment planing of mandibular condyle fractures is very important. The aim of this present study was to evaluate the long-term results according to treatment methods in condylar fractures. Also, it was to evaluate results of treatment according to condylar fracture level. We conducted a retrospective analysis of 43 mandibular condyle fractures. 43 patients followed for average period of 9.00 years(mini. 7yr, max. 12yr). All patients underwent a clinical and radiologic evaluation focusing on mouth opening, mandibular movements, TMJ function, change of ramal height, condylar remodelling. If the level of fracture was positioned in high, especially in level II, mandibular movement disability and ramus length loss was more prominent. This results were similar to the cases of treatment of fragment removal. In high level fracture and fragment removal cases, It is thought that more intensive and long term management are needed than other treatment cases using different operation methods. Also, direct fixation by each approach showed good results in mandibular movement, ramal height change and condylar shape. Through this results, accurate reduction of the mandibular condyle fractures was a very important factor in postoperative prognosis.

• Journal of Yeungnam Medical Science
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• v.19 no.2
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• pp.144-150
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• 2002

Mandibular condylar fracture is common in mandibular fractures. Unlike other facial, skeletal fractures, most of mandibular condylar neck or head fractures are treated with closed reduction and subsequent functional therapy is essential for preventing complications including ankylosis, arthrosis and growth disturbance. From January, 2000 to September, 2002, we have treated 15 cases of mandibular condylar fractures with closed reduction by using functional appliance with bite block. Among these cases, we report a case of 14-year-old female with mandibular condylar neck fracture, resulted in good clinical and radiographic progress.

• The Journal of the Korean dental association
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• v.55 no.10
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• pp.696-705
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• 2017

Condylar fractures account for one-third of all mandibular fractures. There are many surgical methods for the open reduction of condylar fractures, such as the transoral, submandibular, preauricular, and retromandibular approaches. Two patients suffering from condylar fractures, a 45-year-old man and a 25-year-old man, were admitted to our hospital. Both patients' condylar fractures were positioned too high for us to use the transoral approach. Therefore, we employed the retromandibular method to expedite the approach to the fracture site and minimize the size of the incision. After the surgical procedures in both cases, we experienced complications in the form of parotid gland fistulae, which rarely result from the retromandibular approach. A combination of botulinum toxin injection and amitriptyline medication was effective for the management of these parotid gland fistulae. Here, we report these two cases and offer a review of the literature on this article.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.5
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• pp.403-406
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• 2021

The dilemma regarding the management of condylar fractures generally revolves around the surgical approach, implant design, and the surgeon's experience. Zide and Kent's guidelines streamlined the decision making process for condylar fractures. However, there exists no standardized protocol for reduction and fixation of condylar fractures. Here, we have described a detailed and stepwise protocol, common to any surgical approach, that would lead to predictable, reproducible, and repeatable results in every surgeon's hands.