Int. J. Oral Maxillofac. Surg. 2000; 29: 421–427 Copyright C Munksgaard 2000 Printed in Denmark . All rights reserved ISSN 0901-5027 Gaylord S. Throckmorton, Edward Ellis III Recovery of mandibular Division of Oral and Maxillofacial Surgery, University of Texas Southwestern Medicine Center, Dallas, TX, USA motion after closed and open treatment of unilateral mandibular condylar process fractures G. S. Throckmorton, E. Ellis III: Recovery of mandibular motion after closed and open treatment of unilateral mandibular condylar process fractures. Int. J. Oral Maxillofac. Surg. 2000; 29: 421–427. C Munksgaard, 2000 Abstract. The purpose of this study was to determine the rate of recovery of mandibular motion in patients treated for fractures of the mandibular condylar process. One hundred and thirty-six patients (111 men, 25 women), 74 treated by closed and 62 by open methods, were included. They underwent testing of mandibular and condyle mobility at 6 weeks, 6 months, and 1, 2, and 3 years post surgery. Their ranges of motion were compared to those of 52 controls (26 men and 26 women). A jaw-tracking device was used to assess mandibular motion. Multilevel statistical models were used to assess differences between groups, and to estimate rate of recovery in the fracture patients. In general, patients with unilateral fractures of the condylar process had maximum excursions that returned to normal values within 3 years after fracture, regardless of treatment. Patients treated open exhibited a faster rate of improvement in maximum interincisal opening than patients treated closed (0.43 mm/month vs 0.15 mm/month, respectively), but part of the difference was due to a significantly smaller opening after 6 weeks for the patients treated open (38 mm vs 42 mm, respectively). Patients treated open also exhibited a faster rate of improvement in maximum excursion toward the fracture side than patients treated closed (0.10 mm/month vs 0.04 mm/month, respectively). Based upon this study, patients with unilateral fractures of the condylar process, who are treated closed and not put into maxillomandibular fixation but are instructed in physical therapy, can be expected to achieve normal maximum excursions within 3 years after treatment. Patients treated open will have reduced maximum opening initially, but may reach normal levels of opening sooner than patients treated without surgery. Patients treated without surgery may have smaller than normal excursion toward Key words: mandibular condylar fracture; the non-fracture side for at least 3 years after fracture, especially if their fracture mandibular motion. was at or above the condylar neck. Improvement rates for other maximum excursions are similar for patients treated with or without surgery. Accepted for publication 8 June 2000 A previous study comparing mandibu- lar mobility in patients treated for uni- lateral condylar process fractures re- vealed few significant differences be- tween those treated open or closed 12 . Whether or not these patients fully re- cover is unknown because it is imposs- ible to know their pre-traumatic man- dibular mobility. One way to monitor