Long-term follow-up of mandibular condylar fractures in children

Abstract

Purpose: The aim of this prospective study was to evaluate the long-term clinical and radiographic outcomes of nonsurgically treated mandibular condylar fractures in children.

Materials and methods: This study includes 42 children (23 girls and 19 boys) with 54 mandibular condylar fractures. All patients were younger than 18 years at the time of injury and were followed for at least 2 years (mean follow-up 4 years). Treatment was either observation or intermaxillary fixation (rigid and/or guiding elastics). Clinical outcome was categorized as favorable or unfavorable. Condylar remodeling was defined as complete, moderate, or poor on the basis of radiographic findings.

Results: Thirty-one patients (74%) presented with favorable and 11 (26%) with unfavorable clinical long-term outcome. Unilateral fractures showed a statistically significant increase of unfavorable clinical outcomes compared with bilateral fractures (P = .018). The radiologic examinations showed complete remodeling in 47 (87%), moderate remodeling in 5 (9%), and poor remodeling in 2 (4%) of the condylar fractures. One patient developed condylar overgrowth. No statistically significant relationship between clinical and radiologic outcome was found. Thirty-five patients (83%) had no subjective symptoms, and 41 (98%) described normal chewing function at the last follow-up examination.

Conclusions: Nonsurgical treatment of mandibular condylar fractures leads to acceptable remodeling of the condylar process, good clinical long-term outcome, and minimal subjective symptoms in most children. Unilateral fractures significantly increase the risk for unfavorable clinical outcome.