Observation

The patient can eat whatever diet is comfortable. If solid foods cause pain, patients will self-limit their diet to softer foods. There is no contraindication to resuming a regular diet.

Patients are instructed in physical therapy maneuvers to restore mandibular excursions (range of motion exercises). This includes maximum jaw opening, right and left lateral excursions, and protrusive excursions of the mandible. These exercises should be performed several times a day.

It is imperative that the occlusal relationship and mandibular function be assessed early and on a regular basis. The patient is evaluated at one week to verify the occlusion and to assure adequate performance of functional rehabilitation exercises. The frequency of follow-up will be largely based on the findings of that first appointment. Typically, if the patient is doing well after 1 week, the next appointment will 2 weeks later. The necessity and frequency of future appointments will then be based on the findings at this appointment.

Note: Adequate follow-up is essential when choosing observation for condylar fractures. The surgeon should inform the patient and must be prepared to change strategy if the clinical situation does not remain favorable.