Imaging evaluation of condylar remodeling after open reduction and internal fixation of unilateral mandibular condylar fracture in pediatric patients.

Objective: This study aimed to evaluate the radiographic changes in damaged condyles after open reduction and internal fixation (ORIF) in pediatric patients with unilateral condylar fractures.

Study design: We retrospectively analyzed patients aged ≤ 18 years who underwent ORIF for unilateral condylar fractures. The study group comprised fractured condyles, while contralateral healthy condyles served as controls. We assessed post-ORIF condylar remodeling and analyzed the influencing factors. We also compared condylar remodeling before and after internal fixation hardware removal.

Results: The study included 88 patients; for 16 of them, imaging data were obtained after hardware removal. All fractures healed without ankylosis. Patients aged <12 years showed greater susceptibility to irregular condylar morphology and condylar head resorption. Compared with long screw fixation, titanium plate fixation was associated with an increased propensity for condylar head resorption and condylar hyperplasia. Although significant differences in condylar height were observed, the mean difference remained within 2 mm. Postremoval imaging revealed progressive condylar morphological normalization, with no significant height discrepancies.

Conclusions: ORIF restored condylar height but likely adversely affected bone remodeling, with younger children demonstrating greater susceptibility. Condylar morphology gradually normalized after hardware removal; earlier hardware removal was associated with reduced remodeling impact.