Three-dimensional analysis of condylar remodelling after reduction and fixation of mandibular condylar fractures: a retrospective study.

Abstract

Open reduction and internal fixation (ORIF) is the standard treatment for displaced mandibular condyle fractures, yet postoperative condylar remodelling remains insufficiently characterized. The aims of this study were to quantify the three-dimensional condylar remodelling postoperative by analysing immediate postoperative and 6-month computed tomography scans and to assess whether the magnitude of remodelling is associated with surgical or patient-related variables. This retrospective cohort study included 42 adults treated for isolated unilateral condylar fractures. Mandibular models were segmented and superimposed using standardized ramus-based registration. Remodelling was quantified using unsigned surface distance mapping and regional Euclidean distances across five anatomical subregions. Postoperative remodelling was observed consistently across the cohort and was statistically significant (median mean surface distance 0.60 mm; P < 0.001). However, remodelling remained modest in magnitude (mean 0.75 ± 0.53 mm; root mean square 0.94 ± 0.66 mm) with occasional focal deviations. Regional analysis demonstrated heterogeneous patterns, with greater displacement in the superior, medial, and lateral regions and smaller changes posteriorly. No statistically significant associations were identified for surgical approach, fixation plate, age, or sex, suggesting that postoperative adaptation may reflect intrinsic biological and functional processes rather than modifiable technical variables. Clinical outcomes were favourable; complications (predominantly mild and self-limiting) occurred in 28.6% of patients. Events were observed in both endoscope-assisted and open approaches. In conclusion, postoperative condylar remodelling after ORIF is significant, region-dependent, and modest in magnitude, and appears independent of surgical or demographic factors. Three-dimensional surface mapping provides a robust and reproducible method for evaluating postoperative condylar adaptation.