A clinical evaluation of the long-term outcome of patients treated for bilateral fracture of the mandibular condyles.

The object of the study was to present our experience of the treatment of bilateral condylar fractures between 1979 and 1995 and give the long-term outcome. The subjects were 61 patients, of whom 33 attended for review. There were 41 men and 20 women, age range 12-80 years (although nearly all the patients were between 17 and 32 years old). Thirty-one patients (51%) had bilateral fractures of the mandibular condyles alone, the remainder also having another mandibular fracture, usually at the parasymphysis. Over half the patients had been injured in falls. Only 8/122 fractures (7%) were intracapsular, 59 were of the condylar neck (48%), and the remaining 55 (45%) were subcondylar. Nearly half of the fractures were undisplaced. Thirty-nine patients (21%) were treated with wire intermaxillary fixation for a mean of 37 days, 13 (21%) were managed conservatively, and 9 (15%) with 10 fractured condyles were managed by open reduction and internal fixation (ORIF). The most common complaint after treatment was persistent limitation in mouth opening, which was significantly less in the ORIF group mean (SD) 44 mm (2 mm) than in the intermaxillary fixation group 28 mm (2 mm), P < 0.01. It is concluded that if either of the condyles is displaced ORIF is the most satisfactory method of treatment.