Effectiveness of Open Rigid Internal Fixation of Condylar Fracture Resulting in Temporomandibular Joint Function Recovery.

Background

Maxillofacial trauma can impair crucial functions of the stomatognathic system. Mandibular condyle fractures, in particular, often lead to temporomandibular joint (TMJ) dysfunction.

Methods

This study evaluated the effectiveness of open rigid internal fixation (ORIF) in restoring TMJ function, using the Helkimo Index to compare pre- and post-operative outcomes.

Results

A total of 395 patients who underwent ORIF for condylar fractures were analyzed (302 males, 93 females). TMJ function improved significantly from baseline to 6-month follow-up (p < 0.001), with a mean reduction of 2.18 grades on the Helkimo Index. Higher post-operative Helkimo grades (2-3) occurred more frequently during warm months than during cold months (p < 0.05). Low body mass index (BMI) was associated with a greater risk of post-surgical TMJ dysfunction (p < 0.001). TMJ function correlated with facial nerve recovery: patients with poorer pre-operative TMJ function showed additionally slower facial nerve recovery during the first five months after surgery. Age, gender, place of residence, injury characteristics, comorbidities, delay of surgery, duration of surgery, surgical approach, fixing material and laboratory blood tests showed no significant association with post-operative TMJ function. Residual TMJ dysfunction was observed in 3% of treated patients (Di = 3).

Conclusions

ORIF, combined with appropriate post-operative physiotherapy, effectively restores TMJ function after condylar fractures-including severe injuries. Simple clinical indices such as the Helkimo Index reliably capture functional improvement.