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Management of mandibular condylar fractures in patients with atrophic edentulous mandibles - 24/05/20

Doi : 10.1016/j.jormas.2019.10.004 
M. Brucoli a, P. Boffano a, , I. Romeo a, C. Corio a, A. Benech a, M. Ruslin b, T. Forouzanfar c, T. Rodríguez-Santamarta d, J.C. de Vicente d, M. Tarle e, E. Dediol e, P. Pechalova f, N. Pavlov g, H. Daskalov f, I. Doykova h, K. Kelemith i, T. Tamme j, A. Kopchak k, I. Shumynskyi l, P. Corre m, H. Bertin m, M. Bourry m, P. Guyonvarc’h m, T. Dovšak n, D. Vozliè n, A. Birk n, B. Anièiæ o, V.S. Konstantinovic o, T. Starch-Jensen p
a Division of Maxillofacial Surgery, University Hospital “Maggiore della Carità”, University of Eastern Piedmont, Novara, Italy 
b Department of Oral and Maxillofacial Surgery, Hasanuddin University, Makassar, Indonesia 
c Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center, Amsterdam, The Netherlands 
d Servicio de Cirugía Maxilofacial, Hospital Universitario Central de Asturias, Oviedo, Spain 
e Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia 
f Department of Oral surgery, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria 
g Private practice of oral surgery, Plovdiv, Bulgaria 
h Department of maxillofacial surgery, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria 
i Department of maxillo-facial surgery, North Estonia Medical Centre Foundation, Tallinn, Estonia 
j Faculty of Medicine, University of Tartu, Tartu, Estonia 
k Bogomolets National Medical University, Stomatological medical center, Kyiv, Ukraine 
l Bogomolets National Medical University, Kyiv City Clinical Emergency Hospital, Kyiv, Ukraine 
m Division of Maxillofacial Surgery, CHU de Nantes, Nantes, France 
n Department of Maxillofacial and Oral Surgery of the University Medical Centre, Ljubljana, Slovenia 
o Department of Maxillofacial surgery, School of Dental Medicine, University of Belgrade, Serbia 
p Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark 

Corresponding author.

Abstract

Introduction

Treatment of condylar fractures in patients with atrophic edentulous mandibles is a peculiar field that has been little considered in the literature. The aim of the study was to assess the demographic and clinical variables as well as management and outcome of mandibular condylar fractures in edentulous patients with atrophic mandibles that were treated at several European departments of oral and maxillofacial surgery.

Methods

The data of all patients with fractures of the atrophic edentulous mandible from the involved maxillofacial surgical units across Europe between January 1, 2008, and December 31, 2017. Only patients that were diagnosed with condylar fractures of the edentulous atrophic mandible were included.

Results

A total of 52 patients met the inclusion criteria and were included in the study: 79% of patients reported one or more comorbidities. Thirty-four unilateral neck or subcondylar fractures, 9 bilateral neck or subcondylar condylar fractures, 7 unilateral head condylar fractures, and 2 bilateral head condylar fractures were diagnosed. No treatment was performed in 37 cases, whereas in 4 patients a closed treatment was decided, and 11 patients underwent open reduction and internal fixation. Outcome was considered to be satisfying in 48 patients, with no complications.

Conclusions

The golden rule still remains that the diagnosis of a subcondylar or neck fracture in an edentulous patient should constitute an indication for open reduction and internal fixation. However, an appropriate choice of management options has to be individualized on a case by case basis, also depending on the patient consent.

Le texte complet de cet article est disponible en PDF.

Keywords : Condylar fracture, Management, Surgery, Edentulous, Atrophic mandible


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Vol 121 - N° 3

P. 226-232 - juin 2020 Retour au numéro
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