1. Clinical and morphological
evaluation of condyle in unilateral
subcondylar fractures treated by
open reduction and internal
fixation: A Cross-sectional study.
Presenter: Dr. Anita Biswalo,
MDS (VMSDC, Salem),
Fellowship in Maxillofacial Trauma (AMRI Hospitals)
2. CONDYLE
• Diarthroidal joint
• Articulates with TMJ
• Associated to external auditory canal and
middle cranial fossa
• Reducing loads on the overlying bone and
contributing to bone remodeling.
• Attached to pterygoid muscle and temporalis
3.
4. RESEARCH QUESTION ?
Does mandibular condyle
undergoes morphological changes
after ORIF ?
If so, does it cause clinical
dysfunction ?
Does the structural changes in
condyle and the clinical dysfunction
corelate ?
5. METHODOLOGY
• 30 cases
• Post-operative 6 months follow up
• CT scans for radiological evaluation
of condyles of mandible (Choi et al
3013).
• Helkimo Index for clinical
evaluation of Temporomandibular
joint.
INCLUSION EXCLUSION
• Unilateral
subcondylar
fractures
• Condylar fractures
treated with ORIF
• Condylar fractures
+ mandible
fractures
• Bilateral condylar
fractures
• High condylar
fractures
• Condylar fractures
treated
conservatively
• Patients with pre-
existingTMJ
disorders
6.
7.
8.
9.
10.
11. OBSERVATION
CT evaluations of un-
operated side condyle
vs CT evaluations of
operated side condyle
Corelating Helkimo
index and CT
evaluations
12. RESULTS
ON AXIAL SECTION,
• Condylar distance OP < UN-OP
• Condylar length OP > UN-OP
• Condylar angulation OP > UN-
OP
13. ON SAGITTAL SECTION,
• Superior joint space 1 (S1) OP >
UN-OP
• Superior joint space 2 (S2) OP >
UN-OP
• Superior joint space 3 (S3) OP <
UN-OP
17. • In this study, 2 cases had moderately dysfunction Helkimo index and 13 mild dysfunction Helkimo Index.
• Among mandibular condyle fracture parameters, restricted TMJ was observed in 2 (13.3%) cases of operates site.
• No painful mandibular movement was observed in any case of both the sites.
• Muscle pain was observed in 1 (6.7%) cases of operates site and nil cases of unoperated site.
• No painful TMJ was observed in any case of both the sites.
• The mean condylar length at operated site was 1.86±0.21 cm while at unoperated site this length was 1.79±0.21
cm. Therefore, a difference of 0.07±0.11 cm was observed which was statistically significant (p=0.024)
• The mean Posterior Distal Stump Angulation at operated site was 170.59±4.38 degrees while at unoperated
site this angulation was 167.93±4.34 degrees. Therefore, a difference of 2.66±4.54 degrees was observed which
was statistically significant (p=0.040).
18. CONCLUSION
Radiologically, structural
changes on operated side
condyle were clearly
higher, when compared
the same with the values
on the unoperated side
condyle.
On corelating clinical
and radiological
values, structural
changes presented
with more severity of
TMJ dysfunction.
20. REFERNCES
• Choi, Kang-Young et al. Current concepts in the mandibular condyle fracture management part I: overview of
condylar fracture. Archives of plastic surgery 2012;39(4):291-300.
• Tajamul hakim et al. Evaluation of healing joint morphology after closed treatment of moderately displaced
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• Bhupender Singh, Nileena R. Kumar, Anita Balan, Mohammed Nishan, P. S. Haris, M. Jinisha, C. Dimla Denny.
Evaluation of Normal Morphology of Mandibular Condyle: A Radiographic Survey, Journal of Clinical Imaging
Science 2020;10(51):84-87.
• Ren R et al. Comparison of temporomandibular joint function and morphology after surgical and non-
surgical treatment in adult condylar head fractures/ Journal of Cranio-Maxillo-Facial Surgery 2017;48(2):323-
30.
• Okur A, Ozkiris M, Kapusuz Z, Karaçavus S, Saydam L: Characteristics of articular fossa and condyle in patients
with temporomandibular joint complaint. Eur Rev Med Pharmacol Sci 2012;16(5):2131-35.
• Schneider M, Lauer G, Eckelt U. Surgical treatment of fractures of the mandibular condyle: A comparison of
long-term results following different approaches – Functional, axiographical, and radiological findings.
Journal of Cranio-Maxillofacial Surgery 2007;35(3):151–60.
• Siddhartha M, Devireddy S, Kishore Kumar R, Gali R, Kanubaddy S, Dasari M. Three-dimensional assessment
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