Conservative treatment of unilateral condylar fractures in children: a long-term clinical and radiologic follow-up of 55 patients

The purpose of this prospectively designed study was the long-term clinical and radiological evaluation of conservatively treated unilateral condylar fractures in children. Fifty-five children aged between 2 1/2 and 9 3/4 yea rs, presenting with a singular unilateral fracture of the mandibular condyl e, were treated in a nonsurgical-functional way using an intraoral myofunct ional appliance. In the follow-up period, patients were investigated by sta ndardized clinical examination and by evaluation of panoramic radiographs t aken immediately post-traumatically, after 6, 12, 24, 48 and 72 weeks, and then yearly through the period of growth. With a satisfactory clinical cour se in all patients, there was no instance of functional disturbance or mand ibular asymmetry after the respective follow-up periods. The radiographs sh owed a fairly good shape of the condyle (no or only slight condylar deformi ty) in the 47 patients of the 2-6 year age group. In the eight patients of the 7-10 year age group presenting with a class II or III condylar fracture , healing was characterized by incomplete condylar regeneration, resulting in a moderate condylar deformity in two cases, a definite reduction in cond ylar neck height in two cases, and a hypertrophic condylar deformity in fou r cases. The positive results of this study confirm the concept of a nonsur gical-functional approach in children presenting with various types of unil ateral fractures of the mandibular condyle. Condylar remodeling was the mod e of fracture healing in instances of displaced and dislocated condylar fra ctures.