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The Condylar Fracture and Its Types | Diagnosis, Treatment & Recovery | Condylar Fracture Surgery - Dr. Shreya Krishna Condylar fracture repair Condylar fractures The higher incidence of mandibular condylar process fracture is due to the binding of the wide and rigid mandibular ramus to the condyle through a thin and narrow condylar neck. Condylar process fractures can be classified according to their position of the condyle as follows: condylar fracture, condylar neck fracture, and subcondylar fracture. Fractures limited to the condyle are also called intracapsular fracture because the joint capsule extends usually inferiorly to the condylar neck. Condylar neck fractures occur inferior to the area where the joint capsule attaches to the bone; the neck of the condyle is narrower than the condyle. Condylar neck fractures are considered extracapsular fracture because it is not within in the joint capsule. A subcondylar fracture is situated inferiorly to the condylar neck in the area between the mandibular sigmoid notch and posterior border of the mandibular ramus. Conservative therapy remained the primary mode of treatment of mandibular condyle fracture for many years. This is now overshadowed by surgical therapy due to increase in surgical expertise and the advent of new technological advances in both instrumentation and radiological diagnosis. But there exist certain scenarios where conservative treatment is preferred. In closed reduction achievement of good occlusal relationship acts as the guidance for proper reduction. The upper and lower jaws are fixed together in occlusal relationship by means of intermaxillary fixation or maxillomandibular fixation done using wires or splints. The wires that pass through the embrasure space of the adjacent teeth of the same arch are called interdental wires. These are later engaged during intermaxillary wiring. Various modalities of intermaxillary fixation used commonly for condylar fracture are: Wiring: Ivy loop wiring Continuous ivy loop wiring Gilmer wiring Arch bars: Erich’s arch bar Splints: Cap splint in pediatric patients Gunning splints in edentulous patients Indications for conservative treatment: Minimally displaced fracture (Not more than 30°), Pediatric fractures, Presence of systemic comorbidities which may be an absolute contraindication for surgery, Condylar head fracture where there is an increased risk of injury to the joint and the adjoining structures. (Vascularity of the fragment may also be compromised by osteosynthesis). Minimal pain complaints and no occlusal discrepancies with acceptable range of movements. Diacapitular fracture of the condyle Surgical treatment of condylar fractures Conservative treatment using maxillo-mandibular fixation does not always provide satisfactory outcomes. Persistent malocclusion may be present where the necessity for open reduction and internal fixation. Open reduction and internal fixation helps in faster restoration of both form and function unlike conservative treatment. The patient is rehabilitated in a shorter period of time unlike conservative treatment. Some of the indications for open reduction and internal fixation of mandibular condyle fracture includes. Severe displacement of the condyle Mal-united fracture Bilateral condylar fractures with severe displacement or dislocation affecting the occlusion Associated fractures of the mandible Relative indications: When intermaxillary fixation is contraindicated for medical reasons Bilateral fracture with open bite deformity Bilateral fracture with associated comminuted mid face fracture Periodontal problems and loss of teeth Unilateral condylar fracture with unstable base 🌍Website Link- https://www.facesurgeonindia.com https://www.faceitcentre.com --------------------------------------------------------------------------------------------------------------------- Book a consultation with us- Call Us: +91 8056188062 Visit: www.facesurgeonindia.com Mail us: [email protected] WhatsApp- https://wa.me/8056188062 About Dr. Shreya Krishna : Dr. Shreya Krishna is one of the Best Oral and Maxillofacial Surgeon in Delhi, best plastic surgeon in Delhi and best oral surgeon in Delhi. She is expertise for jaw corrective surgery, facial surgery, orthognathic surgery. She is also best chin surgeon in Delhi. She is expert in jaw fracture treatment and orbit fracture treatment. She is the top Jawline Contouring Surgeon. Her core areas of expertise include Corrective Jaw repositioning Surgery using Computer-aided designing and planning, Scarless orbit fracture treatment, Cleft lip and Palate surgeries, Temporomandibular joint surgery, Facial Fracture management, and Oral cyst and tumour management. Dr. Shreya has latest technology for oral maxillofacial surgeries in Delhi. #drshreyakrishna #oralsurgeon #maxillofacialsurgeon #condylarfracture