MRI Evaluation of Disc Position After Nonsurgically Managed Condylar Fracture

• Published in: Journal of the Japanese Society for the Temporomandibular Joint Vol. 10; no. 2; pp. 459 - 467
• Main Authors: TOKUTOMI, Takehiko, TOYOTA, Nagataka, ASADA, Koichi, ISHIBASHI, Katsunori, WATANABE, Akio, MIYAMOTO, Satoshi, ARAI, Tomohiko
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society for Temporomandibular Joint 1998; 一般社団法人 日本顎関節学会
• Subjects: condylar fracture; disc repair; MRI; nonsurgical treatment; 円板修復; 関節突起骨折; 非観血的療法
• ISSN: 0915-3004; 1884-4308
• DOI: 10.11246/gakukansetsu1989.10.459

The purpose of this study was to observe disc repair and investigate reestablishment of the transformed joint by MRI after nonsurgical treatment of condylar fractures. The study was based on 9 unilateral and 6 bilateral condylar process fractures treated in 15 patients. The patients were 11 to 81 years old (mean: 43.5 years). There ware condylar head fracture were 14 joints, condylar neck fracture in 5 joints, and subcondylar fracture in 2 joints. Conservative treatment consisted of early jaw-opening exercise, elastic traction, intermaxillary fixation, and control of the occlusion. After treatment, morphologic changes of the condyle were found in 20 joints. However, in all but was 1 case, pain-free mouth opening with an interincisal distance greater than 40mm were obtained. Condyles were situated at the glenoid fossa or articular eminence when the jaw was closed. All but 1 disc were observed at the superior position relative to the condyle when the jaw was closed. As for jaw movement, all discs sympathetically moved with condyles. In these patients, satisfactory clinical results were obtained. Shortening of the ramus height was brought about by dislocated or displaced condylar fracture, but it was improved by deformed condyle were situated at the lowest point of the articular eminence after healing. The remodeling of the fractured condyle proceeded to a form that adapted well to new location. The repaired discs were located over the deformed and/or displaced condylar head in the jaw closed position and moved sympathetically with the condyle during jaw movement.