Aetiology, Classification, and Co‐Injury Patterns in Mandibular Condylar Fractures: A Retrospective Cross‐Sectional Study of 122 CT ‐Confirmed Cases at a Tertiary Trauma Centre

ABSTRACT Background Mandibular condylar fractures (MCF) constitute a large share of maxillofacial trauma, yet the extent to which routine aetiological categories stratify anatomical location, displacement severity, and co‐injury patterns remains uncertain. Methods Retrospective cross‐sectional study of consecutive, CT‐confirmed MCF at a tertiary trauma centre (Jan 2018–Dec 2020). Fracture location and displacement were classified by Loukota and MacLennan, respectively. Pre‐specified outcomes: distributions of aetiology, anatomical location, displacement class (I–IV), laterality, and concomitant maxillofacial fractures. Associations tested with χ 2 /Fisher's exact; fracture‐line angle compared by one‐way ANOVA. Effect sizes as ORs (95% CIs). Ethics: IR.SUMS.DENTAL.REC.1399.120. Results One hundred twenty‐two patients met the inclusion criteria (94 males; mean age 30.70 ± 11.39 years). RTA predominated (92/122, 75.4%), followed by falls (22/122, 18.0%) and assault (8/122, 6.6%). Unilateral fractures occurred in 91 of 122 (74.6%), while bilateral fractures occurred in 31 of 122 (25.4%). Of 153 fractured condyles, locations were subcondylar 75 (49.0%), neck 69 (45.1%), and head 9 (5.9%); MacLennan classes were III 56 (36.6%), II 38 (24.8%), IV 46 (30.1%), I 13 (8.5%). Aetiology did not significantly stratify anatomical location ( χ 2 , p = 0.292) or displacement class ( χ 2 , p = 0.706). Laterality was informative for co‐injuries: bilateral MCF showed higher odds of symphyseal (67.7% vs. 42.9%; OR = 2.80, 95% CI 1.18–6.62; p = 0.017) and maxillary fractures (38.7% vs. 19.8%; OR = 2.56, 95% CI 1.05–6.22; p = 0.035), whereas mandibular body fractures were less frequent in bilateral than unilateral MCF (6.5% vs. 27.5%; OR = 0.18, 95% CI 0.04–0.82; p = 0.015). The fracture‐line angle for neck/subcondylar injuries did not differ across aetiologies (overall 120.85° ± 11.14°; ANOVA p = 0.711). Conclusions In this CT‐confirmed cohort, RTA predominated; subcondylar/neck injuries, as well as MacLennan III, were most common. Routine aetiology categories did not stratify anatomical location or displacement, whereas laterality mapped to distinct, clinically actionable co‐injury patterns. Findings support targeted imaging and reporting, providing contemporary benchmarks for biomechanics‐aware, multicenter research.