Conservative versus surgical approachs in the treatment of intracapsular condylar fractures: a retrospective study

Abstract

Abstract Background Various procedures have been described for the Intracapsular condylar fractures (ICFs), but a lack of consensus on therapeutic methods. This study aimed to compare the clinical efficacy of conservative management and surgical of intracapsular condylar fractures. Methods This was a retrospective study. Thirty-five patients with unilateral or bilateral intracapsular condylar fractures were divided into two groups between April 2013 and April 2017. The patients in the surgery group were treated with open reduction to remove condylar fracture fragments, and those in the conservative treatment group were treated with manual reduction of the temporomandibular joint. Clinical parameters were assessed, including maximum mouth opening, occlusion, radiographic outcomes, complications, condylar reconstruction assessment using three-dimensional computed tomography, and to evaluate the function of the TMJ by observing the mouth opening function, facial shape, and occlusal relationship. The clinical features and demographic data (age, sex, fracture type, etiology, concomitant fracture, and fracture location) were also recorded. Results Included in the study were 35 patients (47 sides) with intracapsular condylar fractures. There were 30 male patients (85.71%) and 5 female patients (14.29%), with a mean age of 34.2 years (range: 18–59 years). The main mechanism of injury was road traffic accidents (91.43%). Furthermore, we observed that patients treated with the conservative procedure had less than treated with surgery in terms of complications (P < 0.05). No significant differences were observed between the two groups of patients regarding mouth opening and occluding (P > 0.05). Conclusion The results of our study showed no statistically significant difference in the clinical outcomes was found among the groups. Both surgical management and conservative management approaches for intracapsular condylar fractures are associated with significant improvements, but the conservative group had fewer complications.