Further displacement of condylar process fractures after closed treatment

Purpose: This study examined the changes in the position of the fractured c ondylar process immediately before and immediately after application of arc h bars and at 6 weeks after surgery in a group of patients who underwent cl osed treatment. Patients and Methods: Sixty-five patients over the age of 16 years underwen t closed treatment of unilateral mandibular condylar process fractures. Cor onal and sagittal displacement of the condylar process was examined using T owne's and panoramic radiographs before treatment, immediately after placem ent of arch bars, and at 6 weeks. The change in position of the condylar pr ocess from one time to the next was analyzed statistically. Results: There was a statistically significant difference (mean, -5.5 degre es) in the coronal position of the condylar processes from immediately afte r injury to immediately after placement of arch bars. There was great varia bility, with some segments becoming more medially displaced and some more l aterally displaced. In contrast, mean change in the sagittal position of th e condylar process was not statistically significant, although some became more anteriorly and others became more posteriorly displaced. Similarly, fr om immediately after placement of arch bars to 6 weeks, there was great var iability in position of the condylar process, but the overall change was no t statistically significant. Conclusions: The results of this study showed that position of the condylar process is not static in patients treated for condylar process fractures b y closed means. These results suggest that care must be taken in basing tre atment decisions on the degree of displacement or dislocation of the condyl ar process in presurgical radiographs.