Introduction: Condylar fractures can cause serious functional and aesthetic sequelae if inadequately treated. The overall objective of this study was to evaluate the management of these fractures in the Stomatology and Maxillofacial Surgery Department of Sylvanus Olympio University Teaching Hospital in Lomé. PatientsandMethods: This was a retrospective and descriptive study based on medical records of patients hospitalized for a fracture involving the mandibular condyle from January 2015 to December 2023. Results: We collected 49 cases of condylar fractures. The annual frequency was 6.77. The average age of the patients was 32.85 ± 13.25 years, with extremes of 7 years and 80 years. The sex ratio was 11.25. The main etiology was road traffic accidents (85.72%), predominantly involving motorcyclists at 92.84%. The average delay in consultation was 48 hours. Fractures associated condylar and symphyseal regions accounted for 75.52% of the fracture topography. Functional treatment was performed on all patients, surgical treatment on 34.69% of patients, orthopedic treatment on 28.57% of patients, and mixed treatment (orthopedic and surgery) on 12.24% of patients. Sequelae were found in 6.12% of patients. Conclusion: Condylar fractures concerned mainly young adult males. Their management is complex and controversial and should be performed early to avoid complications and sequelae. In Africa, their etiologies are primarily dominated by road traffic accidents, mostly involving two-wheeled vehicles. Emphasis must be placed on prevention, particularly the use of full-face helmets by all motorcyclists.
References
[1]
Toure, G., Meningaud, J. and Bertrand, J. (2004) Fractures de la mandibule. EMC—Dentisterie, 1, 228-243. https://doi.org/10.1016/s1762-5661(04)00078-9
[2]
Zhou, H., Liu, Q., Cheng, G. and Li, Z. (2013) Aetiology, Pattern and Treatment of Mandibular Condylar Fractures in 549 Patients: A 22-Year Retrospective Study. JournalofCranio-MaxillofacialSurgery, 41, 34-41. https://doi.org/10.1016/j.jcms.2012.05.007
[3]
Rutges, J.P.H.J., Kruizinga, E.H.W., Rosenberg, A. and Koole, R. (2007) Functional Results after Conservative Treatment of Fractures of the Mandibular Condyle. BritishJournalofOralandMaxillofacialSurgery, 45, 30-34. https://doi.org/10.1016/j.bjoms.2005.12.001
[4]
Barthélémy, I. and Brix, M. (2017) Chirurgie maxillo-faciale et stomatology. 4ème édition, Elsevier, 394.
[5]
Meyer, C. (2006) Fractures de la région condylienne: Traitement fonctionnel ou chirurgie? RevuedeStomatologieetdeChirurgieMaxillo-faciale, 107, 133-135. https://doi.org/10.1016/s0035-1768(06)77005-x
[6]
Netter, F. (2015) Atlas d’anatomie humaine. 6ème Édition, Elsevier, 624.
[7]
Bissa, H., Pegbessou, E.P., Adam, S., Foma, W., Essolam, T., Amana, E., et al. (2017) Maxillofacial Trauma at Lomé (TOGO): About 501 Cases. Open Journal of Stomatology, 7, 511-518. https://doi.org/10.4236/ojst.2017.712048
[8]
Essobiyou, T.B., Adam, S., Dargani, M.F., Boko, S.U.R., Ananidjin, G., Keheou, A.P., et al. (2022) Mandibular Fracture in a Regional Area: About 109 Cases in Togo. Advances in Oral and Maxillofacial Surgery, 8, Article ID: 100365. https://doi.org/10.1016/j.adoms.2022.100365
[9]
Oumayma, G. (2021) Prise en charge des fractures du condyle mandibulaire: Étude rétrospective et analyse de la littérature. Ph.D. Thesis, Université Sidi Mo-hamed Ben Abdellah.
[10]
Rocton, S., Chaine, A., Ernenwein, D., Bertolus, C., Rigolet, A., Bertrand, J., et al. (2007) Fractures de la mandibule: Épidémiologie, prise en charge thérapeutique et complications d’une série de 563 cas. Revue de Stomatologie et de Chirurgie Maxillo-faciale, 108, 3-10. https://doi.org/10.1016/j.stomax.2006.11.001
[11]
Elmansouri, H. (2019) Les fractures du condyle mandibulaire, notre experience. Ph.D. Thesis, Université de Cadi Ayyad.
[12]
Ahmedou, S. (2021) Prise en charge des fractures du condyle mandibulaire. Ph.D. Thesis, Université de Cadi Ayyad.
[13]
El-Sabbagh, A., Mahgoub, M., Abd El-Latif, E. and Elhadidy, M. (2018) Condylar Fractures: Review of 40 Cases. Annals of Maxillofacial Surgery, 8, 19-27. https://doi.org/10.4103/ams.ams_133_17
[14]
Zachariades, N., Mezitis, M., Mourouzis, C., Papadakis, D. and Spanou, A. (2006) Fractures of the Mandibular Condyle: A Review of 466 Cases. Literature Review, Reflections on Treatment and Proposals. Journal of Cranio-Maxillofacial Surgery, 34, 421-432. https://doi.org/10.1016/j.jcms.2006.07.854
[15]
Vernhet, E., De Boutray, M., Hoarau, R., Jammet, P., Galmiche, S. and Breton, I. (2019) Exclusive Functional Treatment for Mandibular Condylar Fractures. Journal of Oral and Maxillofacial Surgery, 77, 2523.e1-2523.e8. https://doi.org/10.1016/j.joms.2019.06.188
[16]
Bouguila, J., Zairi, I., Khonsari, R.H., Jablaoui, Y., Hellali, M. and Adouani, A. (2008) Epidemiology of Maxillofacial Traumatology in Tunis. Revue de stomatologie et de chirurgie maxillo-faciale, 109, 353-357.
[17]
Ogundare, B.O., Bonnick, A. and Bayley, N. (2003) Pattern of Mandibular Fractures in an Urban Major Trauma Center. Journal of Oral and Maxillofacial Surgery, 61, 713-718. https://doi.org/10.1053/joms.2003.50118
[18]
Tine, S., Tamba, B., Niang, P., Barry, C., Kébé, N. and Guèye, N. (2009) Fractures de la mandibule en pratique odontologique: À propos de 103 cas. MBCB-Journal, 9 p.
[19]
System, R. (2021) Rapports d’analyse. Institut National de la Statistique et des études économiques et démographiques (INSEED).
[20]
Traoré, I., Coulibaly, T.A., Ouedraogo, R.W.L., Zegbeh, N.E.K., Traoré, Y. and Beogo, R. (2021) Mandibular Fractures in Children: From Epidemiology to Treatment at Souro Sanou University Hospital Center: About 54 Cases in Bobo-Dioulasso. Rev Col Odonto-Stomatol Afr Chir Maxillo-fac, 16, 31-34.
[21]
Keita, F. (2023) Fractures du condyle mandibulaire: Aspects épidémiologiques, cliniques et thérapeutiques au CHU-CNOS PR Hamady Traoré de Bamako. Master’s Thesis, Université des sciences techniques et des technologies de Bamako.
[22]
Fridrich, K.L., Pena-Velasco, G. and Olson, R.A.J. (1992) Changing Trends with Mandibular Fractures: A Review of 1,067 Cases. Journal of Oral and Maxillofacial Surgery, 50, 586-589. https://doi.org/10.1016/0278-2391(92)90438-6
[23]
Gérard, E., Nicole N.M.O., Adèle-Rose, N.N., Alain, S. and Charles, B. (2021) Aspects Épidémiologiques, Cliniques et Thérapeutiques des Fractures de la Mandibule à l’Hôpital Central de Yaounde. Health Sciences and Diseases, 22, 85-89.
[24]
Béziat, J.L. and Cresseau, P. (1994) Fractures of the Facial Bones. Diagnosis. Revue Du Praticien, 44, 10 p.
[25]
Lebeau, J. (2011) Chirurgie maxillo-faciale et stomatologie: Pour le 2e cycle des études médicales. Elsevier.
[26]
Meyer, C., Zink, S. and Wilk, A. (2006) La voie d’abord sous-angulo-mandibulaire haute (Voie de Risdon modifiée) pour le traitement des fractures sous-condyliennes de la mandibule. RevuedeStomatologieetdeChirurgieMaxillo-faciale, 107, 449-454. https://doi.org/10.1016/s0035-1768(06)77086-3
[27]
Meyer, C., Martin, E., Kahn, J. and Zink, S. (2007) Development and Biomechanical Testing of a New Osteosynthesis Plate (TCP®) Designed to Stabilize Mandibular Condyle Fractures. JournalofCranio-MaxillofacialSurgery, 35, 84-90. https://doi.org/10.1016/j.jcms.2006.11.006
[28]
Moritz, M., Niederdellmann, H. and Dammer, R. (1994) Mandibular Condyle Fractures: Conservative Treatment versus Surgical Treatment. Revue de Stomatologie et de Chirurgie Maxillo-faciale, 95, 268-273.
