Introduction: The mandibular condyle is a common site of fractures, accounting for approximately 30-50％ of all mandibular fractures. It is an anatomically complex and delicate structure, and the usefulness of surgical treatment for mandibular condylar head fractures has not been clearly established. We performed a retrospective evaluation of patients with condylar head fractures presenting functional impairment, treated with open reduction and internal fixation （OR-IF）.
Patients and Methods: The cases of 11 patients with 11 joints of mandibular condylar head fractures with functional impairment treated with OR-IF at Shimane University Hospital during the period from October 2017 to September 2021 were analyzed. For each patient, the surgery was performed under general anesthesia through a preauricular approach, and the condylar fragment was anatomically reduced and fixed with two or three positioning screws. Age, sex, injury mechanism, concomitant fracture, and complications were reviewed. The functional and structural results were assessed 6 months postoperatively using Nakatomi’s and Kamiya’s assessment scales, respectively.
Results: The patients’ mean age was 68.4 years, and 8 （73％） were male. The most common mechanism of injury was a fall, and all patients had fractures of other sites in maxillofacial bone. Postoperative complications included paralysis of the temporal branch of the facial nerve in two cases, which improved over time. Postoperative evaluations revealed that 72.7％ of the patients achieved complete functional healing, and 90.9％ achieved complete bone healing structurally.
Conclusion: Surgical treatment of mandibular condylar head fractures with functional impairment can be a useful treatment of choice.