Resumo

WASSOUF, A.; VERDEJA, R.  e  GRATZ, K.W.. Conservative treatment of condyle fractures: Radiological and clinical evaluation. Rev Esp Cirug Oral y Maxilofac [online]. 2005, vol.27, n.2, pp.71-77. ISSN 2173-9161.

Benefits of surgical treatment for condylar fractures are to date discussed controversially in the literature. As conservative treatment is the method of choice in our clinic, the purpose of this study is to evaluate the outcomes of a randomised selected group of our patients who received conservative treatment for condylar fractures. The acts of 30 patients (18 males, 12 females, mean age of 25 years) treatment for condylar fractures between 1997 and 2000 with a mean follow up time of 12 months have been assessed. A total of 35 condyle fractures were included in this study. The treatment applied was maxillo-mandibular fixation (MMF) for 2 weeks on unilateral fractures, and 3 - 4 weeks on bilateral fractures. Initial radiological evaluation of the broken condyles angulations and shortening of the ascending ramus was performed. Clinical and radiological examinations were assessed in regular intervals (6 weeks, 3, 6 and 12 months). 5 patients presented bilateral fractures; all of them had anterior dislocation. In the unilateral fracture group 12 presented anterior dislocations (mean value of 23°) on the panoramic x-ray. 13 cases presented posterior dislocation (mean value of 10°). On the (PA) projections 12 fractures presented medial dislocation (mean value of 14°), 4 presented lateral dislocation (mean value of 6°). Ascending ramus shortening reached a mean value of 5.40 mm. Satisfactory function and mobility were observed in all the treated cases. Posttraumatic sequels as TMJ clicking (5 of 29), deviation by mouth opening (14 of 27), reduction of lateral movements and protrusion (in 15 of 29) and finally mouth opening ranged 30 to 60 mm. In conclusion, conservative treatment of condylar fractures is a safe treatment method avoiding surgery with predictable good results. Degree of the displacement or ascending ramus shortening didn’t prevent obtaining good results in this study.

Palavras-chave : Fractures; Maxillo-mandibular fixation; Radiological dislocation.

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