Are Facial Asymmetry and Condylar Displacement Associated With Ramal Height and Treatment Outcomes in Unilateral Condylar Fracture When Managed by the Closed Method?

PURPOSE: This study measured the mandibular ramal height in patients with unilateral condylar fractures managed by the closed method using elastic intermaxillary fixation. Its correlation with facial asymmetry and condylar displacement was assessed. This will determine whether the treatment outcome is in favor of the closed or open method.

MATERIALS AND METHODS: A prospective cohort study was performed. The study included patients with unilateral condylar fractures who reported to SDM Craniofacial Surgery and Research Centre, Dharwad, India. All patients in the study were managed by the closed method (nonsurgically using arch bars and elastic intermaxillary fixation). Standardized panoramic radiographs were used to assess ramal height and condylar displacement in the sagittal plane. Posteroanterior mandible and reverse Towne radiographs were used to assess facial asymmetry and condylar displacement in the coronal plane before treatment; immediately after treatment; and at 3, 6, and 12 months of follow-up. Data were subjected to statistical analysis using the analysis-of-variance test and the Pearson correlation coefficient method.

RESULTS: The study included 25 patients with unilateral condylar fractures managed by closed treatment; they showed a significant reduction in ramal height on the affected side by 1.15 mm (P = .0001) at 12 months' follow-up. The change in facial asymmetry was reported as 1.05 mm (P = .0016) at 12 months' follow-up. Its correlation with ramal height was noted to be insignificant (P = .07). The only significant correlation noted between facial asymmetry and condylar displacement was in the coronal plane at 12 months' follow-up (P = .04).

CONCLUSIONS: A weak positive correlation was noted among the assessed values on radiographs obtained during the 12-month follow-up. Facial symmetry was not greatly affected when the ramal height at the time of injury on the fractured side was reduced by 3.25 ± 0.6 mm.