Conservative treatment outcomes of different types of intracapsular condylar fractures: A 10-year retrospective study.

INTRODUCTION

There is still insufficient evidence to guide surgical versus conservative management of high-level intracapsular condylar fractures. We conducted a quantitative analysis of the conservative treatment outcomes of unicentric intracapsular condylar fractures managed over a 10-year period, with the aim of providing valuable data to inform treatment decision-making for this type of fracture.

MATERIALS AND

METHODS

We retrospectively reviewed the outcomes of 249 patients with a total of 334 intracapsular condylar fractures who underwent conservative treatment. Among them, the numbers of A, B, C, and M subtype cases were 139, 58, 27, and 25, respectively. Regular follow-up was performed to supervise mouth-opening and rehabilitation training. Imaging data were collected for spatiotemporal dynamic analysis, and clinical manifestations were recorded. The functional status of the temporomandibular joint was evaluated using the Helkimo index.

RESULTS

Intracapsular condylar fractures can result in fracture-end union, hyperplasia, or resorption. Most patients had good mouth-opening and occlusal relationship. In type A fractures, the deviation during mouth opening did not occur. In contrast, type B, C, and M intracapsular fractures showed mandibular deviation. Most patients had no obvious temporomandibular joint symptoms or functional impairment.

CONCLUSION

Following conservative treatment of different types of intracapsular condylar fractures, overall remodeling of the fracture fragments and clinical prognosis were generally favorable. Standardized mouth-opening exercises can prevent complete ankylosis and help maintain a certain degree of mouth opening. Conservative treatment for certain types of fractures may result in mandibular deviation.