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Title: Closed Functional Treatment In Patients With Intracapsular Fractures Of The Mandibula Has Limitations

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J Oral Maxillofac Surg 60:784-791, 2002 "Assessment of patients treated for intracapsular fractures of the mandibular condyle by closed techniques"
07/23/2002 11:06:47 AM
By David Ball

Prognosis after closed treatment for different lines of intracapsular fractures of the mandibular condyle can be limited. This is seen in the poor functional and radiologic results found in the fracture types B and M, according to specialists at the Department of Oral and Maxillofacial Surgery, Technical University of Dresden, Germany. They suggest, "Lesions to the osseodiscoligamentous complex of the temporomandibular joint caused by intracapsular fractures of the mandibular condyle can be severe." Forty patients with 50 intracapsular fractures of the mandibular condyle were examined by clinical, radiologic and axiographic follow-up some 22 weeks after closed treatment. The intracapsular fractures fell into three types. These were fractures through the medial condylar pole (type A), fractures through the lateral condylar pole with loss of vertical height of mandibular ramus (type B) and multiple fragments, comminuted fractures (type M). Thirty-three percent of the cases showed moderate to serious dysfunction. Up to a 13 percent reduction in the height of the mandibular ramus was found in comparison with the contralateral side by radiologic examination of fracture types B and M. The most prominent deformations of the condylar head were also found in these two types of fracture. Compared with the non-fractured side, irregular excursions and a limitation of condylar movement in comminuted fractures of up to 74 percent were seen by axiography.

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