Dislocation angle predicts complications following mandibular condylar fracture treatment: a retrospective cohort study.

BACKGROUND

Mandibular condylar fractures are among the most common maxillofacial injuries, yet predictors of postoperative complications remain poorly defined. The role of radiographic dislocation angle as a prognostic factor has received limited attention. This study aimed to identify risk factors for complications following condylar fracture treatment, with particular focus on the predictive value of the dislocation angle.

METHODS

This retrospective cohort study included 184 patients with mandibular condylar fractures treated at a tertiary referral center between 2009 and 2022. Complications were analyzed according to treatment approach (surgical vs. conservative), and potential risk factors were evaluated using univariate and multivariate logistic regression. The dislocation angle was measured on preoperative imaging and stratified into categories (<60°, 60-89°, ≥90°).

RESULTS

The overall complication rate was 29.0% (49/169), predominantly comprising minor events (17.8%), with major complications occurring in only 7.7%. In the surgical subgroup with available angle measurements (n = 91), dislocation angle was significantly associated with complications both in univariate (p = 0.049) and multivariate analysis (OR 1.27 per 10°, 95% CI 1.04-1.57, p = 0.021). Patients with angles <60° had a complication rate of 5.9% compared to 36.0-42.9% for angles ≥60° (p = 0.007). Hardware removal was performed in 43.1% of surgically treated patients.

CONCLUSIONS

Preoperative dislocation angle is an independent predictor of complications following condylar fracture treatment. A preliminary threshold of approximately 60° may serve as a candidate parameter for risk stratification and patient counseling, pending prospective validation.