Untreated Mandibular Condyle Fracture Resulting in TMJ Ankylosis in A Child: A Case Report

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Untreated Mandibular Condyle Fracture Resulting in TMJ Ankylosis in A Child: A Case Report

JJK Lee, CW Lee: Untreated Mandibular Condyle Fracture Resulting in TMJ Ankylosis in A Child: A Case Report. Mal. J. Oral Maxillofac. Surg. 2015; 13: 16–21.

Abstract: Management of temporomandibular joint (TMJ) ankylosis in children has always been fraught with challenges for the Oral and Maxillofacial Surgeon. The most common cause of TMJ ankylosis remains an undiagnosed or untreated condyle fracture of the mandible. Various treatment modalities have been discussed in the literature, the two most common b eing the gap arthroplasty (GA) and interpositional arthroplasty (IA).

In our case here, a 10 year old boy presented with complaint of inability to open his mouth after suffering a fall on his chin when he was 8 months of age. Investigations revealed a radiopaque mass at the left TMJ region signifying a complete bony ankylosis. Following a gap arthroplasty procedure, his mouth opening increased from 1mm to 20mm. He was subsequently put on a strict physiotherapy and jaw exercise regime. At final review 6 months post-op, his mouth opening was noted to have stabilised at 20mm.

TMJ ankylosis is an unfortunate, though rare, sequelae of traumatic injury to the mandibular condyle. Early diagnosis and subsequent close monitoring through regular follow up is essential to prevent or reduce the likelihood of an ankylosis developing. The treatment modality, be it GA or IA, should, first of all, provide sufficient passive opening and secondly, be supplemented with an aggressive regime of jaw exercises. However, all patients and parents should be warned of the possibility of reankylosis and be kept under strict follow up.