Delayed open reduction and single screw internal fixation as a treatment option in cases of failed non-surgical treatment of bilateral condylar head fractures with fragmentation

PurposeTo share our experience in the open reduction and single screw internal fixation of delayed bilateral condylar head fractures with fragmentation and evaluate its feasibility and outcomes.Patients and methodsThe study involved 6 males and 1 female. All patients had multiple injuries at different body sites and failed non-surgical treatment of bilateral condylar head fractures. The mean period between the injury and the operation was 5.7 (4-8) weeks. According to the preoperative computer-aided design, and the clinical manifestations, the fracture fragments were reduced and fixed with a single screw. A helical CT scan was requested postoperatively to check the reduction of the fragments and the location of the screws. Mean follow-up duration was 9.7 (8-14) months.ResultThe malocclusion was corrected after operation. The intraoperative passive mouth opening was 3.93 ± 0.19 cm. The mouth opening was 3.43 ± 0.35 cm in 3 months follow-up, and more than 3 transverse fingers at the last follow up. No one had a progressive limitation of the mouth opening in 8-14 months of follow up.ConclusionsThe strategy of open reduction and single screw internal fixation of bilateral condylar head fracture with fragmentation of mandible is feasible and effective. It is a treatment option in the rare delayed cases of failed non-surgical treatment.