Condyle Fracture in Children

Clinical PaperTrauma

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

J. Choi, N. Oh, I.-K. KimDepartment of Dentistry, College of Medicine,Inha University, Korea

Abstract. This paper reports a long-term clinical and radiological evaluation ofconservatively treated condylar fractures in children. The long-term effects oftreating condylar fractures in children with non-surgical therapy were examined inorder to resolve the controversial question ‘Does complete remodeling occurs at thisage or, if not, is it more likely to be associated with certain types of fractures or otherfactors?’

This study was based on a series of 11 consecutive children and adolescents, agedbetween 3 and 15 years, with fractures of the condylar process who had been treatedwith conservative therapy.

All patients underwent a clinical investigation with a special emphasis on thetemporomandibular joint function and facial asymmetry. The patients alsounderwent a radiological investigation, focusing on the fracture remodeling andsymmetry of the mandible, which consisted of a panoramic radiograph, PA and alateral cephalogram and 3-D CT.

No patient complained of an impaired temporomandibular joint (TMJ) functionor pain on the affected side. Two out of eight (25%) unilateral and one bilateralfracture show a slight facial asymmetry. Despite the apparent excellent recovery offunction, there were marked remodeling changes evident on the CT scan. Suchchanges are not usually evident on a panoramic radiograph. The radiologicalinvestigation showed an incomplete remodeling (six patients, 54.5%) and anasymmetry of the mandible (three patients, 27.3%) in some patients.

Non-surgical treatment of condylar fractures in children results in the satisfactorylong-term outcome of the jaw function despite the relative high frequency ofradiologically noted aberrations.

Accepted for publication 13 April 2005Available online 25 May 2005

Int. J. Oral Maxillofac. Surg. 2005; 34: 851–858doi:10.1016/j.ijom.2005.04.005, available online at http://www.sciencedirect.com

0901-5027/080851+08 $30.00/0 # 2005 Interna

Managing condylar fractures in childrencontinues to be a subject of debate. It hasbeen suggested that these fractures maycreate serious problems if not properlymanaged, for example, growth distur-bances of the face on the injured sideand temporomandibular joint disorderson both the injured and non-injured side.The usually recommended treatment of

tional Association of Oral and Maxillofacial Surgeon

condylar fractures in children has beennon-surgical with a reestablishment ofthe normal occlusion with or without max-illomandibular fixation (MMF) followedby physiotherapy12. In conservative treat-ment, the functional rehabilitation relieson the remodeling capacity of the joint.This is particularly the case in children,because the condyle is a remodeling center

Although the mandibular condyle is one ofthe most common sites of injury to thefacial skeleton, it is also the most over-looked and least diagnosed trauma site inthe head and neck region. In particular,mandibular fractures in children differgreatly from mandibular fractures inadults because of the incomplete dentitionand the growth of the mandible3.

s. Published by Elsevier Ltd. All rights reserved.

852 Choi et al.

that responds to changes in the relation-ship of its surrounding structure duringdevelopment in an adoptive manner,thereby maintaining the normal integrityof the joint during growth2.

Several investigators have reported thetreatment results of condylar fractures inchildren. It appears from these studies thatsatisfactory treatment results have beenobserved following condylar fractures inchildren1,6,16. However, some patientsshow altered growth of the mandible.PROFFIT et al.13 reported that out of 121patients with severe mandibular asymme-try, 5–10% probably were caused by con-dylar fractures. The sequelae to condylarfractures includes ankylosis. In an analysisof 44 cases of ankylosis of the temporo-mandibular joint, TOPAZIAN

19 reported 17cases correlating with a previous trauma tothe joint.

The aim of this study was to examinethe long-term clinical and radiologicalresults of non-surgically treated condylarfractures in children. Therefore, the long-term effects conservative therapy in treat-ing condylar fractures in children wereanalyzed in order to resolve the contro-versial question ‘does complete remodel-ing occurs at this age or, if not, is it morelikely to be associated with certain typesof fractures or other factors?’ The studyalso evaluated whether or not the treat-ment results were satisfactory.

Materials and methods

This study was based on a series of 11consecutive children and adolescents, agedbetween 3 and 15 years, with fractures ofthe condylar process who had previouslybeen treated non-surgically. Table 1 showsthe data from the 11 patients with 14 frac-tured condyles. Patients with isolated con-dylar fractures as well as patients withadditional mandibular fractures wereincluded. Seven of 11 patients had fractures

Table 1. Patients with respect to age, sex and t

Number Sex Age

1 M 15 years 2 months2 M 14 years 8 months

3 F 13 years4 M 11 years 1 month5 F 11 years

6 M 7 years 3 months7 F 6 years 11 months

8 M 6 years9 M 4 years 10 months

10 F 3 years 7 months11 F 3 years 3 months

of the other part of mandible. The follow-upperiod ranged from 1 to 6 years with a meanfollow-up of 3.27 years.

All condylar fractures were treated non-surgically. A short period (2–10 days) ofintermaxillary fixation was used wherethere was excessive pain and/or persistentmalocclusion. When present, fractures ofthe mandibular body were treated with anacrylic splint or rigid internal fixationdepending on the patient’s age and thedisplacement of the fracture.

Fractures were classified as being uni-lateral or bilateral, and the following threelevels of the fracture line location weredistinguished: condylar head or intra-cap-sular fractures, high condylar fracturesand low condylar neck fractures.

The clinical examination was primarilyaimed at detecting possible joint disordersor growth disturbances. Both TMJs wereassessed with regard to pain, clicking,locking and crepitus. The maximummouth opening and deviation from themidline during mouth opening wererecorded. Excursions in the horizontalplane were also measured.

The facial asymmetry and dental mid-line deviation were documented in thecase of a unilateral fracture. In bilateralcases, the anterior–posterior position ofthe mandible and sagittal and vertical openbite as well as the facial asymmetry wasrecorded.

Panoramic radiographs were taken dur-ing the follow-up period 4, 12, 24, and 48weeks 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 ofthe condyle was compared with that on thenon-fractured side. In the cases of bilateralfracture, it was judged as being normal orhaving persistent signs of an earlier frac-ture. A tracing of the condylar head andneck, the ascending ramus and mandibular

ype of condylar fracture

Fx. side Type of Fx.

Lt Condyle headBoth Rt; condyle head

Lt; condyle headLt High condyle neckLt High condyle neckBoth Rt; High condyle neck

Lt; High condyle neckLt Low condyle neckBoth Rt; Intra-capsular

Lt; High condyle neckLt High condyle neckLt Intra-capsularRt Intra-capsularRt Low condyle neck

angle was made. The ramus height wasmeasured as the distance from the gonionto a line drawn tangentially to the top ofthe condyle (Fig. 1). The differences in thelength of the ascending ramus were thenmeasured.

On the cephalogram, lateral projectionswere performed to assess the growth anddevelopment of the jaws and the anglesSNA, SNB and ANB measured. Frontalprojections were also used to assess thefacial asymmetry (Fig. 2).

A CT examination of the condyle wasperformed at the Department of Diagnos-tic radiology, Inha University Hospital(Inchon, Korea) with a high-speed advan-tage (General Electrics, USA). Patientswere placed in the supine position. Thehead position was stabilized by elasticattachments and the scans was recordedwith the teeth in habitual occlusion. SpiralCT scanning was performed with a170 mA scan electric current and a3 mm slice thickness. 3-D reconstructionswere obtained using Virtual work 4.0 soft-ware (3-D analysis software) in variousprojections. 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 angularmeasurements (Fig. 3).

Results

Unilateral condylar fractures

Eight patients had unilateral fractures (fiveboys, three girls: mean age 8.1 years,range 3–15 years), five on the left sideand three on the right. Of the five condylarneck fractures, three were classified asbeing high condylar fractures and two asbeing 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 44 years 6 months 3

2 years 7 months 101 years 9 months 34 years 1 month 0

2 years 10 months 03 years 11 months 7

3 years 1 month 01 years 5 months 01 years 7 months 05 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: themost 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 aperpendicular 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 themandibular body.

a fracture in the symphysis and two in theparasymphysis region.

The mean follow-up period was 2 yearsand 11 months, range 1.5–5.8 years andthe mean age at follow-up was 11 years.There were no complaints of pain or sub-jective restriction of mouth opening. Onepatient recorded TMJ clicking. No patientreported tenderness upon palpation of thejoint area.

Fig. 2. Measurement of deviation of the symph

The mean maximum mouth openingwas 48.62 mm (range 33–58) in twopatients with a slight deviation to thefractured side. The mean maximum pro-trusive movement was 7.88 mm, and themean maximum laterotrusive movementto 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-

ysis. Fig. 3. Illustration of TMJ mea

lity in the three types of fractures wassimilar.

A chin point deviation in the centricocclusion to the fracture side was observedin one patient and the non-injured side inone. A midline deviation in the dentitionto the injured side was registered in onepatient and to the non-injured side in onecase. There was no clear relationship withthe type of fracture (Table 3).

surements.

854 Choi et al.

Table 3. Clinical evaluation of TMJ and growth disturbance

Clinical findings Unilateralfracture (N = 8)

Bilateralfracture (N = 3)

Deviation of Mn. midline in C.O 2 (25%) 0Deviation of midline during M.O 2 (25%) 1Noises in joint 1 (12.5%) 0TMJ pain during mouth opening 0 0TMJ pain during palpation 0 1Malocclusion 2 (25%) 2Facial asymmetry 2 (25%) 1

Table 4. Difference in ramal height among patients with unilateral condylar fractures

Degree of difference in ramal height

Fracture type N None Mild Severe

Low condylar neck 2 1 1 0High condylar neck 3 1 2 0Intracapsular 3 1 2 0

Total 8 3 5 0

None; 0–2 mm mild; 2–4 mm severe; >4 mm.

Table 2. Mean values (mm) and standard deviations for mandibular mobility

Unilateralfracture (N = 8)

Bilateralfracture (N = 3)

Maximal opening 48.62 (8.87) 45.0 (2.12)

Lateral excursionRight 7.80 (2.46) 9.67 (0.58)Left 8.32 (2.27) 8.0 (1)Protrusion 7.88 (2.85) 6.83 (0.29)

Table 5. Radiographic findings on 3-D CT scans in 9 patients with 12 fractured condyles

Frequency Percentage

ShapeEllipsoid 3 25.0Concavo-convex 7 58.3Ovoid 1 8.3Other 1 8.3

Alteration in shapeDeformed 2 25.0Hypoplastic 3 37.5Hyperplastic 3 37.5

Cortical irregularity 8 67Condylar angle compared with the normal side (n = 8) 4 50Condyle position 3 25Flattening of glenoid fossa and articular eminence 4 50

Complete clinical and functional recov-ery was observed in all patients, while aslight facial asymmetry remained in twopatients. Two patients showed malocclu-sion and one patient had orthodontic treat-ment.

On orthopantomogram, the non-surgi-cal treatment resulted in a healing processleading to a normal condyle and condylarneck. This favorable healing processoccurred in 5 (63%) of the patients. In37%, the restoration of the condyle to anormal form had not occurred completely(Fig. 4). However, this had no functionalor aesthetic consequences. A difference inlength between the fractured and contral-ateral ascending ramus was observed infive patients (63%; Table 4).

The frequency of the abnormalitiesdetermined by CT analysis is summarizedin Table 5. The shape of the fracturedcondyles varied: three were ellipsoid, sevenwere concavoconvex and one case wasovoid. The remaining patient had variableshapes. Differences in the condylar anglesof the fractured and non-fractured sides,which indicated a deviation of the condylaraxis, were noted in four patients. Three(37.5%) condylar heads were displacedanterior to the glenoid fossa. Flattening

of the articular eminence was noted in fourjoints (50%) (Table 5).

Six out of eight patients (75%) showedno facial asymmetry. In two patients, aslight facial asymmetry remained, whichwas of no concern to the patient.

Bilateral condylar fractures

Only three patients sustained bilateral con-dylar fractures (one boy, two girls; meanage 10.86 years, range 6.9–14.7 years).

One patient had high condylar fractureson both sides. In the other two patients, anintracapsular fracture on one side wascombined with a low and high condylarneck fracture on the other side, respec-tively. Two patients had associated frac-ture of the symphysis.

The mean follow-up period was 4.17years (range 3.9–4.5 years) and the meanage at the follow-up was 14.69 years(range 10.8–18.2). There were no com-plaints of pain or restriction in mouthopening. One patient reported TMJ click-ing, and another reported tenderness uponpalpation of the joint area (Table 3).

The mean maximum mouth openingwas 45 mm, and deviation from the mid-line was observed in one patient. Themean maximal protrusive movementwas 6.83 mm and the mean maximal later-otrusive movement to both sides was9.67 mm on the right side, and 8.0 mmon the left (Table 2).

Complete clinical recovery wasobserved in all bilateral cases. Signs offacial asymmetry were observed in onecase and slight retrognathia with a class IImalocclusion were noted in two patients.However, there was no open-bite. In onepatient, a small midline deviation of thedentition was present.

In two patients, a restoration of thenormal shape of the condyle was achieved.However, in one patient, a shortening of3 mm on the right side was observed(Fig. 5)

The 3-D reconstruction of the onepatient showed a deformed and hyperplas-tic condyle. The remodeled condylar headwas located more anteriorly than on thecontralateral side. The condyle was dis-located moderately anteriorly and someasymmetry was noted (Fig. 5). The othertwo cases showed an almost normal TMJstructure, except for a slight flattening ofthe temporal bone.


Fig. 4. TMJ images of a 15-year-old female who sustained left high condyle neck fracture at theage of 13. (A) Coronal plane CT image showing high condyle neck fracture immediately aftertrauma. (B) Axial 3-CT scan: axial view shows ovoid shape and hypoplastic condyle compare tonormal right condyle.

Discussion

Several investigators have reported thetreatment results of condylar fractures inchildren. In general, satisfactory treatmentresults have been observed following con-dylar fractures in children. However, THO-

REN et al.18 reported that more than half oftheir patients had subjective symptoms

and almost two thirds showed clinicalsigns of dysfunction. In this study, regard-ing the functional clinical evaluation,good recovery of the TMJ function wasnoted in unilateral and bilateral fracture.

In the conservative treatment of frac-tured condyle in children, GUVEN &KESKIN

5 report that their patients weretreated by custom made arch bars and

intermaxillary fixation for 12–17 days.And each patient then underwent a func-tional treatment consisting of passivemouth opening exercise. THOREN et al.18

stated that some patients had no treatmentand were given dietary restriction only,and others had intermaxillary fixation for10–24 days. HOVINGA et al.6 also statedthat the treatment consisted of reassuranceand explanation, and in some cases, inwhich the proper occlusion could not bereached initially, two weeks of MMF fol-lowed by guiding elastics were applied.STROBL et al.16 reported that the patientswere treated in a nonsurgical-functionalfashion for a period of four to six months,using an intraoral, myofunctional activa-tor without the additional use of precedingMMF. However, SAHM & WITT

15 statedthat all patients in their study receivedIMF for 2–3 weeks and after that weretreated with a removable functional ortho-paedic appliance. In this study, a shortperiod of intermaxillary fixation was usedwhere there was excessive pain and/orpersistent malocclusion (Table 1), allpatients received active physical exerciseusing rubber elastic traction. Five patientshad no IMF and were given physical ther-apy only. The remaining six had IMF for2–10 days (mean: 4.8 days). Six additionalfractures were treated with acrylic resinsplint and circum-mandibular wiring andone mandibular symphysis fracture withminiplate osteosynthesis.

GUVEN & KESKIN5 suggested that a mea-

surement of the maximal interincisal dis-tance is a very good indicator of the TMJfunction, and a difficulty in mouth openingis accompanied by other TMJ dysfunc-tions such as limited lateral, anterior andposterior excursions of the mandible andpoor mastication. They report that theaverage maximum interincisal distanceon mouth opening was 38.3 mm rangingfrom 34 to 43 mm. The average maximummouth opening in our patients was48.62 mm in those with unilateral frac-tures and 44.3 mm in those with a bilateralfracture. These findings are comparablewith 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 thecontralateral side was 8.4 and 7.8 mm,respectively. CASCONE et al.1 reported thatthe lateral movement values recovered to9.3 mm for the right side and 9.2 mm forthe left side. The results of the currentfollow-up evaluation are similar to thosereported in other studies. KAHL-NIEKE

et al.8 stated the clinical criteria for afollow-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 neckfracture 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 viewedfrom infero-lateral aspect; the right is hypoplastic and deformed.


teria, the clinical results of this study arefavorable and satisfactory.

MCGUIRT11 reported that 13 out of the

28 (46%) subjects reported TMJ poppingnoises, and 5 of these 13 complained ofdiscomfort when they yawned or openedtheir mouths widely. HOVINGA et al.6 statedthat TMJ function was undisturbed in allof his patients. STROBL et al.16, GUVEN &KESKIN

5, and THOMPSON et al.17 reportedthat the symptoms and signs of a dysfunc-tion were very slight. In this study, click-ing of the joint was observed in one casewith unilateral fracture and TMJ tender-ness to palpation existed in another casewith a bilateral fracture, which is consis-tent with the long-term findings of theTMJ function from other authors.

Numerous reports on mandibulargrowth following pediatric condylar frac-ture suggest that non-surgical manage-ment produces satisfactory results.LUND

10 reported six patients (22%)showed evidence of retarded growth onthe fractured side. GILHUUS-MOE

4 found adeviation of the mandible toward the frac-tured side in 14 out of 43 patients withunilateral fractures (33%). He alsoreported an overgrowth of the fracturedcondyle. HOVINGA et al.6 stated that aconsiderable growth disturbance wasobserved in two patients in their study.THOMPSON et al.17 identified seven class IImalocclusion and one open bite in 23cases. From this study, there were twopatients with unilateral fractures whohad a malocclusion and somewhat facialasymmetry. Two out of three bilateralcondylar fractures had a slight malocclu-sion and one patient showed facial asym-metry. The results might show that agrowth disturbance was more frequentwhen associated with bilateral condylarfractures. This is in accordance with theresults reported by THOMPSON et al.17.HOVINGA et al.6 reported that 54.5% ofthe unilateral and 83.3% of the bilateralfractures did not show any growth distur-bance. They showed that low condylar andintracapsular fractures gave rise to thelargest number of facial asymmetries. Thisstudy was unable to show any correlationbetween the type of condyle fracture andthe growth disturbance, which will beexamined in a further investigation.

In this study, of five patients with facialasymmetry or malocclusion, four patientshad additional fracture of mandible.Nearly all the patients with facial asym-metry or malocclusion had other fractureof the mandible, which might be anotherfactor that contribute to these problems.Because of relatively small size of ourstudy population, we were unable to relate

their problems and associate fracture ofthe mandible.

Ankylosis of the TMJ is an extremelyrare and a serious complication of a con-dylar fracture but there was no ankylosisnoted in this series

Regarding the relationship between ageand the remodeling capacity, DAHLSTROM

et al.2 reported that almost twice as manysubjects in the oldest group experiencedsymptoms of dysfunction. In 1997, DIMI-

TROULIS3 reported that a favorable outcome

was most likely to occur in patients under10 years of age where the remodelingpotential was greatest, and in some post-pubertal adolescents, dysplastic growthmight occur, whereby the growth of themandible may become progressivelyasymmetrical as a result of a reducedgrowth and remodeling potential on theside of the fractured mandibular condyle.ROWE

14 stated that injuries inflicted before3 years of age will produce a severeasymmetric deformity; those inflictedafter 6 years of age, a moderate deformity;and those after 12 years of age, only slightdeformity. LINDAHL & HOLLENDER

9 com-pared the process of remodeling the con-dylar after a fracture in children andadults, and reported that between 3 and11 years of age, extensive remodeling ofthe condylar fractures generally resulted ina normal anatomy. NORHOLT et al.12 alsofound that younger children had fewerlong-term problems from their injuriesthan their older counterparts. It was notpossible to demonstrate any correlationbetween the age and the remodeling capa-city in this study. In general, a tendencytoward an increasing possibility of dys-plastic growth with increasing age at thetime of trauma was noted.

In the past, a morphologic evaluationhas been based primarily on the panoramicradiographic film. In this study, on theorthopantomogram, the ramus heightwas measured and the shape of the con-dyle was compared with that on the non-fractured side. Bilateral fractures werejudged as either being normal or havingpersistent signs of the earlier fracture.Using panoramic radiographs, GUVEN &KESKIN

5 reported that the remodeling ofthe condyle head was good in 17, whilemoderate remodeling occurred in the otherfour condyles. Three out of eight unilateralcondyle fracture patients did not show anydifference in the ramus height in thisstudy, five patients showed mild differ-ences (�4 mm) in the ramus height andnone of these patients showed severe dif-ference (�4 mm).

Nowadays, CT scanning plays a keyrole in assessing the condylar state and

the position after fractures as well as indiagnosis. Computed tomography (CT)offers the possibility of examining thestate of the TMJ without a superimpositionof the adjacent structures. Recent devel-opments in CT technology have enabledexcellent 2-D and 3-D reformatted imagesin different anatomic planes to allow adetailed examination. From this study,3-D CT imaging appears to be a valuablediagnostic aid in cases of condyle fractureswhere severe morphological changes werenot recognized in earlier conventional X-ray examinations. It was possible to eval-uate both quantitatively and qualitativelythe effects of treatment on the condyle sizeand shape, sclerosis and cortical irregula-rities, condylar and intercondylar angle,joint position, neck length, depth of gle-noid fossa, and flattening of the articulareminence. A similar view was expressedby SAHM & WITT

15 and KAHL et al.7.In 1995, using 3-D CT, KAHL et al.7

reported that 11 patients with 13 differenttypes of condyle fractures showed arestoration of the normal function with afavorable remodeling and the remainingeight patients had only a good functionwith a deformed condyle and significantasymmetry in the condylar angle andlength of the condylar neck. From theresults of this study, 25% of the patientsshowed a change in the condyle position,50% had asymmetric condylar angles andeight condyles showed abnormal shapes.Despite the apparent excellent functionalrecovery, there was marked remodelingchanges evident on the CT scan. Suchchanges were not usually evident on thepanoramic radiograph.

Several examples of a bifid condylewere reported in the literature11,12. Manyauthors, such as LUND

10 and LINDAHL &HOLLENDER

9, suggested it to be caused byan insufficient remodeling capacity or byan abnormal growth generated by theposition of the articular disc. In this series,one patient, who sustained bilateral con-dyle fractures, showed bony exostosis ofthe condyle head (Fig. 5).

The remodeling process after a condylarfracture is not limited to the condyles butalso involves a flattening of the mandib-ular fossa. This was histologically demon-strated proved by GILHUUS-MOE

4 usinganimal experiments. Similar observationswere reported by THOMPSON et al.17, LIN-

DAHL & HOLLENDER9 and SAHM & WITT

15 intheir studies of condylar fracture in chil-dren. There were four cases of a slightglenoid flattening in this study. In caseswhere there was a significant difference inthe ramus height with a consequent resorp-tion of the proximal segment, the facial

858 Choi et al.

asymmetry appears to be less conspicuouswith a relatively low frequency of TMJsymptoms.

In conclusion, non-surgical treatment ofdislocated condylar process fractures inchildren has satisfactory long-term out-come of jaw function despite the highfrequency of radiologically noted aberra-tions. Serious growth disturbances arerare, but cannot be predicted based onthe fracture type. These results are inaccordance with other studies, and con-firm that conservative treatment is pre-ferred when condylar fractures occur inchildren.

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Address:Jinho ChoiDepartment of DentistryCollege of MedicineInha University7-206 3rd ST Shinheung-DongChoong-GuInchonKoreaTel: +82 32 890 2470/1Fax: +82 32 890 2475E-mail: [email protected]

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Condyle Fracture in Children