Complications in the treatment of mandibular condylar fractures: Surgical versus conservative treatment

Objectives: In the present article, we aim to review the main intra-and post-operative complications associated with two different therapeutic approaches for treating mandibular condylar fractures: conservative (CTR) and surgical treatment (ORIF, Open Reduction and Internal Fixation). Material and methods: We have carried out a retrospective, meta-analytic, observational study using literature review, covering the period between 2000-September 2017. The data obtained were processed using statistical software SPSS v.0.18 and R v.2.11.1. The chi-squared test was used for comparison of relative frequencies for independent samples. Results: A total of 2458 patients with 2810 fractures were collected for study. Patients treated with CTR and ORIF were an average of 29 years old, of those treated with CTR, 72.37% and 27.63% were male or female respectively and, of those treated with ORIF, 70.36% and 29.64% were male or female respectively. The main complications suffered by CTR and ORIF patients were: asymmetry (10.2%/6.4%), residual pain (6.5%/5.6%), temporomandibular joint and articular imbalance (15.9%/10.3%) and malocclusion (11.1%/4.0%), respectively. We only found significant differences between CTR and ORIF in the number of cases of temporomandibular joint and articular imbalance and malocclusion. Facial nerve damage was found exclusively among ORIF patients (8.6%) of which 8.3% were temporary and 0.3% permanent. Conclusions: The complications associated with either technique are minimal and infrequent, resulting in successful outcomes with minimal morbidity. CTR are associated with complications deriving from delayed mobilization leading to functional limitation, whereas the main complication associated with ORIF treatment was facial nerve damage. (C) 2017 Elsevier GmbH. All rights reserved.