2016 Volume 28 Issue 1 Pages 28-34
We report our clinical experience with three cases of temporomandibular joint (TMJ) ankylosis resulting from condylar fractures. Case 1 was a 42-year-old male involved in a traffic accident presenting with mandibular fractures: bilateral lateral dislocation of the mandibular condyles with a sagittal fracture and a parasymphyseal fracture resulting in inter-ramus width widening. The parasymphyseal fracture was treated by open reduction; the bilateral condylar fractures were treated conservatively. One year after the accident, he visited our department because of trismus. Bilateral TMJ ankylosis was diagnosed. Gap arthroplasty, coronoidectomy, and interpositional grafting with temporalis muscle flap were performed. The maximum mouth opening was 42 mm with no recurrence 1 year postoperatively. Case 2 was a 35-year-old female with left subcondylar, coronoid, and parasymphyseal fractures. The treatment of the fracture was the same as that for Case 1. Two years later, bilateral TMJ ankylosis was diagnosed. Osteoarthrotomy was performed. The maximum mouth opening was 40 mm with no recurrence one and a half years postoperatively. Case 3 was a 28-year-old female with right condylar head and symphyseal fractures. Open reduction and internal fixation were performed. One and a half years later, right TMJ ankylosis was diagnosed. Osteoarthrotomy was performed. The maximum mouth opening was 45 mm with no recurrence 8 years postoperatively. When treating condylar fractures, it is necessary to consider the risk of post-traumatic sequelae such as TMJ ankylosis.
