Are facial asymmetry and condylar displacement associated with ramus height and treatment outcomes in unilateral condylar fracture when managed by closed method?

Publication date: Available online 26 November 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Mohit Bindal, Abhijit Joshi, Adithi Bhat, Venkatesh Anehosur

Purpose

This study measures the mandibular ramal height in patients with unilateral condylar fracture managed by closed method using elastic intermaxillary fixation (IMF). It's co-relation with facial asymmetry and condylar displacement were assessed. This will determine whether the treatment outcome is in favour of closed or open method.

Methodology

A prospective cohort study was performed. Subjects included patients with unilateral condylar fracture who reported to SDM Craniofacial & Research Centre, Dharwad, India. All subjects in the study were managed by closed method (non-surgically, using arch bars and elastic IMF). Standardised orthopantomogram radiographs were used to assess ramal height and condylar displacement in sagittal plane. PA mandible and reverse Towne's radiographs were used to assess facial asymmetry and condylar displacement in coronal plane during pre-treatment, immediate post-treatment, 3^rd, 6^th and 12^th month follow-up. Data was subjected to statistical analysis by using ANOVA test and Karl Pearson's correlation coefficient method.

Results

25 patients with unilateral condylar fracture managed by closed treatment had significant reduction in ramal height on the affected side by 1.15mm (p=0.0001) at 12^th month follow-up. Change in facial asymmetry was reported as 1.05mm (p=0.0016) at 12^th month follow-up. It was noted that its correlation with ramal height was insignificant (p=0.07). Only significant correlation noted between facial asymmetry and condylar displacement was in coronal plane at 12^th month follow-up (p=0.04).

Conclusion

A weak positive co-relation was noted among the assessed values during the 12^th month follow-up radiographs. Facial symmetry is not greatly affected when the ramal height at the time of injury on the fractured side is reduced by 3.25±0.6mm.

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