A 2 year follow-up self-controlled study on morphological changes in the musculoskeletal apparatus after conservative treatment of condylar head fracture

Abstract

Abstract To reveal morphological changes in musculoskeletal apparatus after conservative treatment of condylar head fracture (CHF) by clinical examinations, condylar and masticatory muscle reconstruction, to guide the clinical therapeutic strategy. Patients with unilateral CHF and treated conservatively during November 2015 to January 2020 were enrolled and followed up for 2 years. Clinical assessments (mouth open, mandible deviation and occlusal relationship), and CT reconstruction (condyle, ramus height, masseter and lateral pterygoid) immediately and 2 years after fracture were compared with the unfractured side as control group. Mixed-effect analysis and two-way ANOVA were manipulated and P ≤ 0.05 was defined as significant. 26 patients were involved. The average of maximum mouth opening increased from 12.6 ± 5.40 mm to 27.8 ± 8.60 mm. Significant musculoskeletal resorption with an average condyle volume decrease of 241.86 mm3 (P = 0.0029), ramus height decrease of 1.87 mm (P = 0.0004), masseter volume decrease of 3,447.3 mm3 (P < 0.0001), and lateral pterygoid volume decrease of 1203.05 mm3 (P = 0.0049) occurred. No significant changes occurred to the unfractured sides. Conservative treatment of CHF displayed significant musculoskeletal resorption. Clinical assessments showed less optimal improvements. Surgeons should be aware of these trends and take full consideration before applying nonsurgical treatment.

Keywords

• Musculoskeletal morphology
• Masseter muscle
• Pterygoid muscles
• Condylar head fracture
• Conservative treatment