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  • Title: [Clinical, radiological and axiographic examination after conservative functional treatment of intracapsular temporomandibular joint fractures].
    Author: Hlawitschka M, Eckelt U.
    Journal: Mund Kiefer Gesichtschir; 2002 Jul; 6(4):241-8. PubMed ID: 12242933.
    Abstract:
    PURPOSE: The different lines of intracapsular fractures of the mandibular condyle were studied and their influence on the prognosis following close treatment was evaluated. METHODS: In 40 patients with 50 intracapsular fractures of the mandibular condyle the following evaluation was carried out after close treatment: clinical, radiological and axiographical follow-up. The examinations were performed between 0.5-5 years following treatment. Three types of intracapsular fractures were distinguished. Type A = fractures through the medial condylar pole, type B = fractures through the lateral condylar pole with loss of vertical height of mandibular ramus, type M = multiple fragments, comminuted fractures. RESULTS: Moderate to serious dysfunction was observed in 33% of the cases. Radiological examination of fracture types B and M revealed a reduction in the height of the mandibular ramus by up to 13% as compared to the contralateral side. Also with regard to deformation of the condylar head these two fracture types resulted in the most prominent pathological findings. Axiography revealed irregular excursions and a clear limitation of condylar movement in comminuted fractures by up to 74% as compared to the non-fractured side. CONCLUSION: The findings emphasize the severity of lesions to the osseo-disko-ligamentous complex of the TMJ caused by intracapsular fractures of the mandibular condyle. The poor functional and radiological results encountered in the fracture types B and M demonstrated the limits of conservative functional treatment. With regard to fracture type B it may be discussed whether surgical therapy would improve the results.
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