Open treatment of condylar process fractures: Assessment of adequacy of repositioning and maintenance of stability

Purpose: This study was designed to determine how well fractured condylar processes were reduced and the stability of the internal fixation in a group of patients whose fractures were treated by open reduction. Patients and Methods: Sixty-one patients treated by open reduction and internal fixation for unilateral condylar process fractures were studied prospectively using Towne's and panoramic radiographs. The radiographs were made before surgery, and immediately, 6 weeks, and 6 months postoperatively. The images were traced and digitized, and the position of the fractured condylar process was statistically compared with the position of the nonfractured condylar process in both the coronal and sagittal planes. Additionally, 2 observers examined the images and assessed these same 2 factors. Results: After surgery, the difference in position between the fractured and nonfractured sides averaged less than 2 degrees (not significantly different), indicating good reduction of the fractures. However, subsequently, between 10% and 20% of condylar processes had postsurgical changes in position of more than 10 degrees. Conclusions: This study showed that it is possible to anatomically reduce the fractured condylar process, but changes in position of the condylar fragment may then result from a loss of fixation.