Int. J. Oral Maxillofac. Surg.

2005; 34: 851–858

doi:10.1016/j.ijom.2005.04.005, available online at http://www.sciencedirect.com

Clinical Paper
Trauma

A follow-up study of condyle J. Choi, N. Oh, I.-K. Kim

Department of Dentistry, College of Medicine,
Inha University, Korea

fracture in children
J. Choi, N. Oh, I.-K. Kim: A follow-up study of condyle fracture in children. Int. J. Oral
Maxillofac. Surg. 2005; 34: 851–858. # 2005 International Association of Oral and
Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Abstract. This paper reports a long-term clinical and radiological evaluation of

conservatively treated condylar fractures in children. The long-term effects of
treating condylar fractures in children with non-surgical therapy were examined in
order to resolve the controversial question ‘Does complete remodeling occurs at this
age or, if not, is it more likely to be associated with certain types of fractures or other
factors?’
This study was based on a series of 11 consecutive children and adolescents, aged
between 3 and 15 years, with fractures of the condylar process who had been treated
with conservative therapy.
All patients underwent a clinical investigation with a special emphasis on the
temporomandibular joint function and facial asymmetry. The patients also
underwent a radiological investigation, focusing on the fracture remodeling and
symmetry of the mandible, which consisted of a panoramic radiograph, PA and a
lateral cephalogram and 3-D CT.
No patient complained of an impaired temporomandibular joint (TMJ) function
or pain on the affected side. Two out of eight (25%) unilateral and one bilateral
fracture show a slight facial asymmetry. Despite the apparent excellent recovery of
function, there were marked remodeling changes evident on the CT scan. Such
changes are not usually evident on a panoramic radiograph. The radiological
investigation showed an incomplete remodeling (six patients, 54.5%) and an
asymmetry of the mandible (three patients, 27.3%) in some patients.
Non-surgical treatment of condylar fractures in children results in the satisfactory
long-term outcome of the jaw function despite the relative high frequency of Accepted for publication 13 April 2005
radiologically noted aberrations. Available online 25 May 2005

Although the mandibular condyle is one of
the most common sites of injury to the
facial skeleton, it is also the most over-
looked and least diagnosed trauma site in
the head and neck region. In particular,
mandibular fractures in children differ
greatly from mandibular fractures in
adults because of the incomplete dentition
and the growth of the mandible3.
Managing condylar fractures in children
continues to be a subject of debate. It has
been suggested that these fractures may
create serious problems if not properly
managed, for example, growth distur-
bances of the face on the injured side
and temporomandibular joint disorders
on both the injured and non-injured side.
The usually recommended treatment of
condylar fractures in children has been
non-surgical with a reestablishment of
the normal occlusion with or without max-
illomandibular fixation (MMF) followed
by physiotherapy12. In conservative treat-
ment, the functional rehabilitation relies
on the remodeling capacity of the joint.
This is particularly the case in children,
because the condyle is a remodeling center

0901-5027/080851+08 $30.00/0 # 2005 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
852 Choi et al.
that responds to changes in the relation-
ship of its surrounding structure during
development in an adoptive manner,
thereby maintaining the normal integrity
of the joint during growth2.
Several investigators have reported the
treatment results of condylar fractures in
children. It appears from these studies that
satisfactory treatment results have been
observed following condylar fractures in
children1,6,16. However, some patients
show altered growth of the mandible.
PROFFIT et al.13 reported that out of 121
patients with severe mandibular asymme-
try, 5–10% probably were caused by con-
dylar fractures. The sequelae to condylar
fractures includes ankylosis. In an analysis
of 44 cases of ankylosis of the temporo-
mandibular joint, TOPAZIAN19 reported 17
cases correlating with a previous trauma to
the joint.
The aim of this study was to examine
the long-term clinical and radiological
results of non-surgically treated condylar
fractures in children. Therefore, the long-
term effects conservative therapy in treat-
ing condylar fractures in children were
analyzed in order to resolve the contro-
versial question ‘does complete remodel-
ing occurs at this age or, if not, is it more
likely to be associated with certain types
of fractures or other factors?’ The study
also evaluated whether or not the treat-
ment results were satisfactory.
Materials and methods
This study was based on a series of 11
consecutive children and adolescents, aged
between 3 and 15 years, with fractures of
the condylar process who had previously
been treated non-surgically. Table 1 shows
the data from the 11 patients with 14 frac-
tured condyles. Patients with isolated con-
dylar fractures as well as patients with
additional mandibular fractures were
included. Seven of 11 patients had fractures
Table 1. Patients with respect to age, sex and type of condylar fracture
Number Sex Age
1 M 15 years 2 months
2 M 14 years 8 months
3 F 13 years
4 M 11 years 1 month
5 F 11 years
6 M 7 years 3 months
7 F 6 years 11 months
8 M 6 years
9 M 4 years 10 months
10 F 3 years 7 months
11 F 3 years 3 months
of the other part of mandible. The follow-up
period ranged from 1 to 6 years with a mean
follow-up of 3.27 years.
All condylar fractures were treated non-
surgically. A short period (2–10 days) of
intermaxillary fixation was used where
there was excessive pain and/or persistent
malocclusion. When present, fractures of
the mandibular body were treated with an
acrylic splint or rigid internal fixation
depending on the patient’s age and the
displacement of the fracture.
Fractures were classified as being uni-
lateral or bilateral, and the following three
levels of the fracture line location were
distinguished: condylar head or intra-cap-
sular fractures, high condylar fractures
and low condylar neck fractures.
The clinical examination was primarily
aimed at detecting possible joint disorders
or growth disturbances. Both TMJs were
assessed with regard to pain, clicking,
locking and crepitus. The maximum
mouth opening and deviation from the
midline during mouth opening were
recorded. Excursions in the horizontal
plane were also measured.
The facial asymmetry and dental mid-
line deviation were documented in the
case of a unilateral fracture. In bilateral
cases, the anterior–posterior position of
the mandible and sagittal and vertical open
bite as well as the facial asymmetry was
recorded.
Panoramic radiographs were taken dur-
ing the follow-up period 4, 12, 24, and 48
weeks after the trauma. At the follow-up,
each patient had a panoramic radiograph,
frontal and lateral cephalogram and three-
dimensional CT taken.
On the orthopantomogram, the shape of
the condyle was compared with that on the
non-fractured side. In the cases of bilateral
fracture, it was judged as being normal or
having persistent signs of an earlier frac-
ture. A tracing of the condylar head and
neck, the ascending ramus and mandibular
Fx. side Type of Fx.
Lt Condyle head
Both Rt; condyle head
Lt; condyle head
Lt High condyle neck
Lt High condyle neck
Both Rt; High condyle neck
Lt; High condyle neck
Lt Low condyle neck
Both Rt; Intra-capsular
Lt; High condyle neck
Lt High condyle neck
Lt Intra-capsular
Rt Intra-capsular
Rt Low condyle neck
angle was made. The ramus height was
measured as the distance from the gonion
to a line drawn tangentially to the top of
the condyle (Fig. 1). The differences in the
length of the ascending ramus were then
measured.
On the cephalogram, lateral projections
were performed to assess the growth and
development of the jaws and the angles
SNA, SNB and ANB measured. Frontal
projections were also used to assess the
facial asymmetry (Fig. 2).
A CT examination of the condyle was
performed at the Department of Diagnos-
tic radiology, Inha University Hospital
(Inchon, Korea) with a high-speed advan-
tage (General Electrics, USA). Patients
were placed in the supine position. The
head position was stabilized by elastic
attachments and the scans was recorded
with the teeth in habitual occlusion. Spiral
CT scanning was performed with a
170 mA scan electric current and a
3 mm slice thickness. 3-D reconstructions
were obtained using Virtual work 4.0 soft-
ware (3-D analysis software) in various
projections. According to the TMJ struc-
ture revealed by 3-D CT, the TMJ mor-
phometry (size, condylar angle, position)
was determined by the linear and angular
measurements (Fig. 3).
Results
Unilateral condylar fractures
Eight patients had unilateral fractures (five
boys, three girls: mean age 8.1 years,
range 3–15 years), five on the left side
and three on the right. Of the five condylar
neck fractures, three were classified as
being high condylar fractures and two as
being low. Three fractures were consid-
ered to be intra-capsular fractures
(Table 1). Of these patients, five had addi-
tional fractures of the mandible; three had
F/U time IMF (days)
4 years 10 months 4
4 years 6 months 3
2 years 7 months 10
1 years 9 months 3
4 years 1 month 0
2 years 10 months 0
3 years 11 months 7
3 years 1 month 0
1 years 5 months 0
1 years 7 months 0
5 years 10 months 2
 A follow-up study of condyle fracture in children 853

Fig. 1. Measurement of ramus height. Con: the most superior point of the condyle; Cor: the most superior point of the coronoid process; Inc: the
most inferior point of the mandibular notch; C: the intersection of the RL and a perpendicular line from Con; I: the intersection of the RL and a
perpendicular line from Inc; G: the intersection of the RL and ML; RL: a tangent line of the mandibular ramus; and ML: a tangent line of the
mandibular body.

a fracture in the symphysis and two in the
parasymphysis region.
The mean follow-up period was 2 years
and 11 months, range 1.5–5.8 years and
the mean age at follow-up was 11 years.
There were no complaints of pain or sub-
jective restriction of mouth opening. One
patient recorded TMJ clicking. No patient
reported tenderness upon palpation of the
joint area.
The mean maximum mouth opening
was 48.62 mm (range 33–58) in two
patients with a slight deviation to the
fractured side. The mean maximum pro-
trusive movement was 7.88 mm, and the
mean maximum laterotrusive movement
to the side of fracture and to the contra-
lateral side was 7.80 mm (range 5.3–12)
and 8.32 mm (range 5.9–11), respec-
tively (Table 2). The degree of jaw mobi-
lity in the three types of fractures was
similar.
A chin point deviation in the centric
occlusion to the fracture side was observed
in one patient and the non-injured side in
one. A midline deviation in the dentition
to the injured side was registered in one
patient and to the non-injured side in one
case. There was no clear relationship with
the type of fracture (Table 3).

Fig. 2. Measurement of deviation of the symphysis. Fig. 3. Illustration of TMJ measurements.

854 Choi et al.

Table 2. Mean values (mm) and standard deviations for mandibular mobility One patient had high condylar fractures
Unilateral Bilateral on both sides. In the other two patients, an
fracture (N = 8) fracture (N = 3) intracapsular fracture on one side was
Maximal opening 48.62 (8.87) 45.0 (2.12) combined with a low and high condylar
neck fracture on the other side, respec-
Lateral excursion tively. Two patients had associated frac-
Right 7.80 (2.46) 9.67 (0.58) ture of the symphysis.
Left 8.32 (2.27) 8.0 (1)
Protrusion 7.88 (2.85) 6.83 (0.29)
The mean follow-up period was 4.17
years (range 3.9–4.5 years) and the mean
age at the follow-up was 14.69 years
(range 10.8–18.2). There were no com-
Table 3. Clinical evaluation of TMJ and growth disturbance plaints of pain or restriction in mouth
Clinical findings Unilateral Bilateral opening. One patient reported TMJ click-
fracture (N = 8) fracture (N = 3) ing, and another reported tenderness upon
Deviation of Mn. midline in C.O 2 (25%) 0 palpation of the joint area (Table 3).
Deviation of midline during M.O 2 (25%) 1 The mean maximum mouth opening
Noises in joint 1 (12.5%) 0 was 45 mm, and deviation from the mid-
TMJ pain during mouth opening 0 0 line was observed in one patient. The
TMJ pain during palpation 0 1 mean maximal protrusive movement
Malocclusion 2 (25%) 2 was 6.83 mm and the mean maximal later-
Facial asymmetry 2 (25%) 1 otrusive movement to both sides was
9.67 mm on the right side, and 8.0 mm
on the left (Table 2).
Table 4. Difference in ramal height among patients with unilateral condylar fractures Complete clinical recovery was
Degree of difference in ramal height observed in all bilateral cases. Signs of
facial asymmetry were observed in one
Fracture type N None Mild Severe
case and slight retrognathia with a class II
Low condylar neck 2 1 1 0 malocclusion were noted in two patients.
High condylar neck 3 1 2 0 However, there was no open-bite. In one
Intracapsular 3 1 2 0
patient, a small midline deviation of the
Total 8 3 5 0 dentition was present.
None; 0–2 mm mild; 2–4 mm severe; >4 mm. In two patients, a restoration of the
normal shape of the condyle was achieved.
However, in one patient, a shortening of
Complete clinical and functional recov- of the articular eminence was noted in four 3 mm on the right side was observed
ery was observed in all patients, while a joints (50%) (Table 5). (Fig. 5)
slight facial asymmetry remained in two Six out of eight patients (75%) showed The 3-D reconstruction of the one
patients. Two patients showed malocclu- no facial asymmetry. In two patients, a patient showed a deformed and hyperplas-
sion and one patient had orthodontic treat- slight facial asymmetry remained, which tic condyle. The remodeled condylar head
ment. was of no concern to the patient. was located more anteriorly than on the
On orthopantomogram, the non-surgi- contralateral side. The condyle was dis-
cal treatment resulted in a healing process located moderately anteriorly and some
Bilateral condylar fractures
leading to a normal condyle and condylar asymmetry was noted (Fig. 5). The other
neck. This favorable healing process Only three patients sustained bilateral con- two cases showed an almost normal TMJ
occurred in 5 (63%) of the patients. In dylar fractures (one boy, two girls; mean structure, except for a slight flattening of
37%, the restoration of the condyle to a age 10.86 years, range 6.9–14.7 years). the temporal bone.
normal form had not occurred completely
(Fig. 4). However, this had no functional
or aesthetic consequences. A difference in Table 5. Radiographic findings on 3-D CT scans in 9 patients with 12 fractured condyles
length between the fractured and contral-
ateral ascending ramus was observed in Frequency Percentage
five patients (63%; Table 4). Shape
The frequency of the abnormalities Ellipsoid 3 25.0
determined by CT analysis is summarized Concavo-convex 7 58.3
in Table 5. The shape of the fractured Ovoid 1 8.3
Other 1 8.3
condyles varied: three were ellipsoid, seven
were concavoconvex and one case was Alteration in shape
ovoid. The remaining patient had variable Deformed 2 25.0
shapes. Differences in the condylar angles Hypoplastic 3 37.5
of the fractured and non-fractured sides, Hyperplastic 3 37.5
which indicated a deviation of the condylar Cortical irregularity 8 67
axis, were noted in four patients. Three Condylar angle compared with the normal side (n = 8) 4 50
(37.5%) condylar heads were displaced Condyle position 3 25
anterior to the glenoid fossa. Flattening Flattening of glenoid fossa and articular eminence 4 50

Fig. 4. TMJ images of a 15-year-old female who sustained left high condyle neck fracture at the
age of 13. (A) Coronal plane CT image showing high condyle neck fracture immediately after
trauma. (B) Axial 3-CT scan: axial view shows ovoid shape and hypoplastic condyle compare to
normal right condyle.
Discussion
Several investigators have reported the
treatment results of condylar fractures in
children. In general, satisfactory treatment
results have been observed following con-
dylar fractures in children. However, THO-
18
REN et al. reported that more than half of
their patients had subjective symptoms
A follow-up study of condyle fracture in children
and almost two thirds showed clinical
signs of dysfunction. In this study, regard-
ing the functional clinical evaluation,
good recovery of the TMJ function was
noted in unilateral and bilateral fracture.
In the conservative treatment of frac-
tured condyle in children, GUVEN &
KESKIN5 report that their patients were
treated by custom made arch bars and
855
intermaxillary fixation for 12–17 days.
And each patient then underwent a func-
tional treatment consisting of passive
mouth opening exercise. THOREN et al.18
stated that some patients had no treatment
and were given dietary restriction only,
and others had intermaxillary fixation for
10–24 days. HOVINGA et al.6 also stated
that the treatment consisted of reassurance
and explanation, and in some cases, in
which the proper occlusion could not be
reached initially, two weeks of MMF fol-
lowed by guiding elastics were applied.
STROBL et al.16 reported that the patients
were treated in a nonsurgical-functional
fashion for a period of four to six months,
using an intraoral, myofunctional activa-
tor without the additional use of preceding
MMF. However, SAHM & WITT15 stated
that all patients in their study received
IMF for 2–3 weeks and after that were
treated with a removable functional ortho-
paedic appliance. In this study, a short
period of intermaxillary fixation was used
where there was excessive pain and/or
persistent malocclusion (Table 1), all
patients received active physical exercise
using rubber elastic traction. Five patients
had no IMF and were given physical ther-
apy only. The remaining six had IMF for
2–10 days (mean: 4.8 days). Six additional
fractures were treated with acrylic resin
splint and circum-mandibular wiring and
one mandibular symphysis fracture with
miniplate osteosynthesis.
GUVEN & KESKIN5 suggested that a mea-
surement of the maximal interincisal dis-
tance is a very good indicator of the TMJ
function, and a difficulty in mouth opening
is accompanied by other TMJ dysfunc-
tions such as limited lateral, anterior and
posterior excursions of the mandible and
poor mastication. They report that the
average maximum interincisal distance
on mouth opening was 38.3 mm ranging
from 34 to 43 mm. The average maximum
mouth opening in our patients was
48.62 mm in those with unilateral frac-
tures and 44.3 mm in those with a bilateral
fracture. These findings are comparable
with other studies: CASCONE et al.1
reported 44.3 mm and HOVINGA et al.6
reported 49.3 mm. GUVEN & KESKIN5
reported that the average lateral move-
ment to the side of fracture and to the
contralateral side was 8.4 and 7.8 mm,
respectively. CASCONE et al.1 reported that
the lateral movement values recovered to
9.3 mm for the right side and 9.2 mm for
the left side. The results of the current
follow-up evaluation are similar to those
reported in other studies. KAHL-NIEKE
et al.8 stated the clinical criteria for a
follow-up evaluation. Based on their cri-
856 Choi et al.

Fig. 5. TMJ images of a 15-year-old female who sustained a dislocated high condyle neck fracture of the right and displaced high condyle neck
fracture of the left at the age of 11. (A) Coronal CT image and (B) panoramic radiograph show bilateral fracture immediately after trauma. (C)
Severe deformity of the right condyle after follow-up period of 4 years in same patient. (D and E) 3-D reconstruction of right and left TMJ viewed
from infero-lateral aspect; the right is hypoplastic and deformed.

teria, the clinical results of this study are
favorable and satisfactory.
MCGUIRT11 reported that 13 out of the
28 (46%) subjects reported TMJ popping
noises, and 5 of these 13 complained of
discomfort when they yawned or opened
their mouths widely. HOVINGA et al.6 stated
that TMJ function was undisturbed in all
of his patients. STROBL et al.16, GUVEN &
KESKIN5, and THOMPSON et al.17 reported
that the symptoms and signs of a dysfunc-
tion were very slight. In this study, click-
ing of the joint was observed in one case
with unilateral fracture and TMJ tender-
ness to palpation existed in another case
with a bilateral fracture, which is consis-
tent with the long-term findings of the
TMJ function from other authors.
Numerous reports on mandibular
growth following pediatric condylar frac-
ture suggest that non-surgical manage-
ment produces satisfactory results.
LUND10 reported six patients (22%)
showed evidence of retarded growth on
the fractured side. GILHUUS-MOE4 found a
deviation of the mandible toward the frac-
tured side in 14 out of 43 patients with
unilateral fractures (33%). He also
reported an overgrowth of the fractured
condyle. HOVINGA et al.6 stated that a
considerable growth disturbance was
observed in two patients in their study.
THOMPSON et al.17 identified seven class II
malocclusion and one open bite in 23
cases. From this study, there were two
patients with unilateral fractures who
had a malocclusion and somewhat facial
asymmetry. Two out of three bilateral
condylar fractures had a slight malocclu-
sion and one patient showed facial asym-
metry. The results might show that a
growth disturbance was more frequent
when associated with bilateral condylar
fractures. This is in accordance with the
results reported by THOMPSON et al.17.
HOVINGA et al.6 reported that 54.5% of
the unilateral and 83.3% of the bilateral
fractures did not show any growth distur-
bance. They showed that low condylar and
intracapsular fractures gave rise to the
largest number of facial asymmetries. This
study was unable to show any correlation
between the type of condyle fracture and
the growth disturbance, which will be
examined in a further investigation.
In this study, of five patients with facial
asymmetry or malocclusion, four patients
had additional fracture of mandible.
Nearly all the patients with facial asym-
metry or malocclusion had other fracture
of the mandible, which might be another
factor that contribute to these problems.
Because of relatively small size of our
study population, we were unable to relate
A follow-up study of condyle fracture in children
their problems and associate fracture of
the mandible.
Ankylosis of the TMJ is an extremely
rare and a serious complication of a con-
dylar fracture but there was no ankylosis
noted in this series
Regarding the relationship between age
and the remodeling capacity, DAHLSTRÖM
et al.2 reported that almost twice as many
subjects in the oldest group experienced
symptoms of dysfunction. In 1997, DIMI-
3
TROULIS reported that a favorable outcome
was most likely to occur in patients under
10 years of age where the remodeling
potential was greatest, and in some post-
pubertal adolescents, dysplastic growth
might occur, whereby the growth of the
mandible may become progressively
asymmetrical as a result of a reduced
growth and remodeling potential on the
side of the fractured mandibular condyle.
ROWE14 stated that injuries inflicted before
3 years of age will produce a severe
asymmetric deformity; those inflicted
after 6 years of age, a moderate deformity;
and those after 12 years of age, only slight
deformity. LINDAHL & HOLLENDER9 com-
pared the process of remodeling the con-
dylar after a fracture in children and
adults, and reported that between 3 and
11 years of age, extensive remodeling of
the condylar fractures generally resulted in
a normal anatomy. NORHOLT et al.12 also
found that younger children had fewer
long-term problems from their injuries
than their older counterparts. It was not
possible to demonstrate any correlation
between the age and the remodeling capa-
city in this study. In general, a tendency
toward an increasing possibility of dys-
plastic growth with increasing age at the
time of trauma was noted.
In the past, a morphologic evaluation
has been based primarily on the panoramic
radiographic film. In this study, on the
orthopantomogram, the ramus height
was measured and the shape of the con-
dyle was compared with that on the non-
fractured side. Bilateral fractures were
judged as either being normal or having
persistent signs of the earlier fracture.
Using panoramic radiographs, GUVEN &
KESKIN5 reported that the remodeling of
the condyle head was good in 17, while
moderate remodeling occurred in the other
four condyles. Three out of eight unilateral
condyle fracture patients did not show any
difference in the ramus height in this
study, five patients showed mild differ-
ences (4 mm) in the ramus height and
none of these patients showed severe dif-
ference (4 mm).
Nowadays, CT scanning plays a key
role in assessing the condylar state and
857
the position after fractures as well as in
diagnosis. Computed tomography (CT)
offers the possibility of examining the
state of the TMJ without a superimposition
of the adjacent structures. Recent devel-
opments in CT technology have enabled
excellent 2-D and 3-D reformatted images
in different anatomic planes to allow a
detailed examination. From this study,
3-D CT imaging appears to be a valuable
diagnostic aid in cases of condyle fractures
where severe morphological changes were
not recognized in earlier conventional X-
ray examinations. It was possible to eval-
uate both quantitatively and qualitatively
the effects of treatment on the condyle size
and shape, sclerosis and cortical irregula-
rities, condylar and intercondylar angle,
joint position, neck length, depth of gle-
noid fossa, and flattening of the articular
eminence. A similar view was expressed
by SAHM & WITT15 and KAHL et al.7.
In 1995, using 3-D CT, KAHL et al.7
reported that 11 patients with 13 different
types of condyle fractures showed a
restoration of the normal function with a
favorable remodeling and the remaining
eight patients had only a good function
with a deformed condyle and significant
asymmetry in the condylar angle and
length of the condylar neck. From the
results of this study, 25% of the patients
showed a change in the condyle position,
50% had asymmetric condylar angles and
eight condyles showed abnormal shapes.
Despite the apparent excellent functional
recovery, there was marked remodeling
changes evident on the CT scan. Such
changes were not usually evident on the
panoramic radiograph.
Several examples of a bifid condyle
were reported in the literature11,12. Many
authors, such as LUND10 and LINDAHL &
HOLLENDER9, suggested it to be caused by
an insufficient remodeling capacity or by
an abnormal growth generated by the
position of the articular disc. In this series,
one patient, who sustained bilateral con-
dyle fractures, showed bony exostosis of
the condyle head (Fig. 5).
The remodeling process after a condylar
fracture is not limited to the condyles but
also involves a flattening of the mandib-
ular fossa. This was histologically demon-
strated proved by GILHUUS-MOE4 using
animal experiments. Similar observations
were reported by THOMPSON et al.17, LIN-
9 15
DAHL & HOLLENDER and SAHM & WITT in
their studies of condylar fracture in chil-
dren. There were four cases of a slight
glenoid flattening in this study. In cases
where there was a significant difference in
the ramus height with a consequent resorp-
tion of the proximal segment, the facial
858 Choi et al.
asymmetry appears to be less conspicuous
with a relatively low frequency of TMJ
symptoms.
In conclusion, non-surgical treatment of
dislocated condylar process fractures in
children has satisfactory long-term out-
come of jaw function despite the high
frequency of radiologically noted aberra-
tions. Serious growth disturbances are
rare, but cannot be predicted based on
the fracture type. These results are in
accordance with other studies, and con-
firm that conservative treatment is pre-
ferred when condylar fractures occur in
children.
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Address:
Jinho Choi
Department of Dentistry
College of Medicine
Inha University
7-206 3rd ST Shinheung-Dong
Choong-Gu
Inchon
Korea
Tel: +82 32 890 2470/1
Fax: +82 32 890 2475
E-mail: jinho98@inha.ac.kr