condylar process fractures
Condylar process fractures are fractures of the condylar process of the mandible. The condylar process of the mandible is involved in around 30% of all mandibular fractures.
Condylar fractures are classified according to the location of the fracture and the direction displacement of the condyle relative to the ramus.
Location
Fractures are either through the condylar neck or the head:
- head
- intracapsular
- extracapsular (similar to high neck fracture)
- neck
- high (similar to extracapsular head fracture)
- mid
- low
Displacement
Fractures can be either displaced or non-displaced. When displacement is present, it is most frequently medial (i.e. direction of condyle relative to ramus; note that this violates the usual description of fractures which is the usually the distal part relative to the proximal part) due to the action of the lateral pterygoid muscle.
Additionally, and important in deciding treatment, is the degree of contraction (shortening) in the vertical plane.
Radiographic features
Traditionally OPGs and plain films have been the mainstay of imaging, although facial CT is increasingly being used. The role of MRI in the acute setting is unclear but is likely to become more prevalent if and when early intervention on disc and capsule injury is shown to be beneficial.
Treatment and prognosis
- conservative
- closed reduction
- closed reduction and intermaxillary fixation +/- splints
- open reduction (ORIF)
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