Treatment of condylar fractures: therapeutic controversies continue…

Mandibular condyle fractures: evaluation of the Strasbourg Osteosynthesis Research Group classification

Condylar fractures (CFs) are about 30% of mandibular fractures. Condylar fractures are treated with several protocols, and unsatisfying outcome is achieved in some cases. A staging system for classifying CFs is of paramount importance to plan therapy, to define prognosis, and to exchange information among trauma centers. The Strasbourg Osteosynthesis Research Group proposed a classification system for CFs, but no report focusing to its effectiveness is still available. Thus, we performed a retrospective study on a series of patients affected by CFs.The Strasbourg Osteosynthesis Research Group classification defines 3 main types of CFs: diacapitular fracture (i.e., through the head of the condyle [DF]), fracture of the condylar neck, and fracture of the condylar base (CBF). A series of 66 patients (and 84 CFs) was evaluated, and age, sex, clinical diagnosis at admission, treatment, and outcome were considered.Fractures of the condylar base and DFs are the most (52.4%) and the least (4.8%) frequent fractures, respectively. Conversely, associated fractures of the facial skeleton are found in most cases of DFs (75%) and in few cases of CBFs (20.5%). Surgery was performed in about 15% of all cases: no DF was operated, whereas fractures of the condylar neck and CBFs have an open reduction and an internal rigid fixation in 57% and 43%, respectively. Postsurgical and late sequelae were 22.3% and 19%. Temporomandibular joint symptoms and malocclusion cover about 80% and 90% of postsurgical and late sequelae.The new classification is a simple method to define CFs and can give some elements about the prognosis.