A Comparative Analysis of Surgical and Conservative Management in Intra-Articular Condylar Fractures: A Retrospective Study

Background: Mandibular condylar fractures are among the most common fractures of the facial skeleton, and their surgical management remains a topic of considerable debate in maxillofacial trauma surgery. Numerous studies in the literature internationally have explored optimal treatment approaches, with a growing preference for open reduction and internal fixation (ORIF). While conservative treatment has traditionally been the standard for intra-articular fractures, recent research suggests that ORIF may also be appropriate for selected cases of these fractures. Methods: This study presents a 14-year review (2009–2023) of the authors’ experience in the surgical management of intra-articular condylar fractures. Data were collected on surgical techniques, early and late complications, clinical and radiological outcomes, and comparisons with conservative treatment. Results: The analysis included evaluations of both short-term and long-term outcomes following ORIF, identifying specific scenarios where ORIF demonstrated advantages over conservative management. Clinical and radiographic assessments provided valuable insights into patient recovery and functional outcomes, while complication rates were documented for both treatment methods. Conclusions: Findings indicate that ORIF can be a beneficial treatment option for intra-articular condylar fractures in select patient groups, offering improved outcomes in cases where conservative treatment may be insufficient. However, conservative management remains a valid approach when surgical risks exceed potential benefits. This study adds to the ongoing discussion, supporting a tailored approach that considers individual patient factors when choosing between ORIF and conservative treatment.