Treatment outcome in mandibular condylar fractures.

Whether surgical or conservative therapy is indicated in mandibular condylar fractures remains controversial because there are no definitive criteria on which to base this decision. We treated 144 patients with a diagnosis of mandibular condylar fracture at the First Department of Oral and Maxillofacial Surgery, Kyushu Dental College Hospital during the 9-year-period from 1986 through 1994. Seventy-seven of the 144 patients responded to a questionnaire, and 32 patients were recalled. We analyzed the outcome of treatment for mandibular condylar fracture. The results were as follows.1. Analysis of the questionnaire indicated no difference between the surgical treatment group and the conservative treatment group with regard to clinical outcome. However, the clinical outcome after the enucleation of fractured fragments was bad.2. In the conservative treatment group, the clinical outcome of cases involving dislocated and disarticulated mandibular condylar fractures at the upper neck and head was bad in patients who were 30 years of age or older.3. As for the morphological outcome, the surgical treatment group was better than the conservative treatment group.Future studies should investigate indications for surgical treatment in patients with mandibular fractures who are over 30 years old, those in whom the fractured fragment can undergo reduction, and those with dislocation and disarticulation at the upper neck and head.