Facial Plast Surg 2000; 16(2): 193-206
DOI: 10.1055/s-2000-12579
Copyright © 2000 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Condylar Process Fractures of the Mandible

Edward Ellis III
  • Oral and Maxillofacial Surgery, University of Texas Southwestern Medical Center, Dallas, TX
Further Information

Publication History

Publication Date:
31 December 2000 (online)

ABSTRACT

Treatment of condylar process fractures is a highly debated topic because available minimal scientific evidence is concerning outcomes comparing open and closed treatment. Decisions on treatment are therefore based more upon experience, training, and whim rather than upon outcome data. This article presents the author's open and closed techniques for treating condylar process fractures and briefly discusses considerations about which fractures deserve open treatment.

REFERENCES

  • 1 Ekholm A. Fractures of the condyloid process of the mandible.  Suomen Hammaslaakariseuran Toimituksia . 1961;  57 9-80
  • 2 Rowe N L, Killey H C. Fractures of the Facial Skeleton, 2nd ed. Edinburgh: E&S Livingstone 1968: 234
  • 3 Tasanen A, Lamberg M A. Transosseous wiring in the treatment of condylar fractures of the mandible.  J Maxillofac Surg . 1976;  4 200
  • 4 Olson R A, Fonseca R J, Zeitler D L. Fractures of the mandible: a review of 580 cases.  J Oral Maxillofac Surg . 1982;  40 23
  • 5 Silvennoinen U, Iizuka T, Oikarinen K, Lindqvist C. Analysis of possible factors leading to problems after nonsurgical treatment of condylar fractures.  J Oral Maxillofac Surg . 1994;  52 793
  • 6 Walker R V. Discussion: open reduction of condylar fractures of the mandible in conjunction with repair of discal injury: a preliminary report.  J Oral Maxillofac Surg . 1988;  46 262
  • 7 Georgiade N, Pickrell K, Douglas W, Altany F. Extraporal pinning of displaced condylar fractures.  Plast Reconstr Surg . 1956;  18 377
  • 8 Raveh J, Vuillemin T, Lädrach K. Open reduction of the dislocated, fractured condylar process: indications and surgical procedures.  J Oral Maxillofac Surg . 1989;  47 120
  • 9 Takenoshita Y, Ishibashi H, Oka M. Comparison of functional recovery after nonsurgical and surgical treatment of condylar fractures.  J Oral Maxillofac Surg . 1990;  48 1191
  • 10 Worsaae N, Thorn J J. Surgical versus nonsurgical treatment of unilateral dislocated low subcondylar fractures: a clinical study of 52 cases.  J Oral Maxillofac Surg . 1994;  52 353
  • 11 Beekler D M, Walker R V. Condylar fractures.  J Oral Surg . 1969;  27 563
  • 12 Agerberg G, Lundberg M. Changes in the temporomandibular joint after surgical treatment.  Oral Surg . 1971;  32 865
  • 13 Converse J M. The Surgical Treatment of Facial Injuries, 3rd ed. Kazanjian V, Converse JM, eds.  Baltimore: William & Wilkins 1974: 197-201
  • 14 James R B, Frederickson C, Kent J H. Prospective study of mandibular fractures.  J Oral Surg . 1981;  39 275
  • 15 Hohman A, Wilson K, Nelms Jr R C. Surgical treatment in temporomandibular joint trauma.  Otolaryngol Clin North Am . 1983;  16 549
  • 16 Zide M F, Kent J N. Indications for open reduction of mandibular condyle fractures.  J Oral Maxillofac Surg . 1983;  41 89
  • 17 Zide M F. Open reduction of mandibular condyle fractures, indications and technique.  Clin Plast Surg . 1989;  16 69
  • 18 Schettler D, Rehrmann A. Long-term results of functional treatment of condylar fractures with long bridle according to A. Rehrmann.  J Maxillofac Surg . 1975;  3 14
  • 19 Ikemura K. Treatment of condylar fractures associated with other mandibular fractures.  J Oral Maxillofac Surg . 1985;  43 810
  • 20 Desault P J. Treatise on Fractures, Luxation and Other Affections of Bones. Philadelphia: Fry and Kammerer; 1805
  • 21 Ivy R H, Curtis L. Fractures of the Jaws. Philadelphia: Lea & Febiger 1931: 78
  • 22 Walker D G. Fractures of ramus, condyloid and coronoid processes of mandible.  Br Dent J . 1942;  72 265-293
  • 23 Schüle H. Injuries of the temporomandibular joint. In: Oral and Maxillofacial Traumatology, vol 2. Krüger E, Schilli W, eds. Chicago: Quintessence 1986: 45-70
  • 24 Walker R V. Traumatic mandiblar condylar dislocations.  Am J Surg . 1960;  100 850
  • 25 Boyne P J. Osseous repair and mandibular growth after subcondylar fractures.  J Oral Surg . 1967;  25 300
  • 26 Thiele R B, Marcoot R M. Functional therapy for fractures of the condyloid process in adults.  J Oral Maxillofac Surg . 1985;  43 226
  • 27 Upton L G. Management of injuries to the temporomandibular joint region. In: Oral and Maxillofacial Trauma, Fonseca RJ, Walker RV, eds. Philadelphia: WB Saunders 1991: 418-434
  • 28 Walker R V. Condylar fractures: non-surgical management.  J Oral Maxillofac Surg . 1994;  52 1185
  • 29 Amaratunga N A. Mouth opening after release of MMF in fracture patients.  J Oral Maxillofac Surg . 1987;  45 383
  • 30 Koberg W R, Momma W-G. Treatment of fractures of the articular process by functional stable osteosynthesis using miniaturized dynamic compression plates.  Int J Oral Surg . 1978;  7 256
  • 31 Curphey J E. The fracture dislocation of the temporomandibular joint. In: Proceedings of the 8th International Conference on Oral and Maxillofacial Surgery. Hjorting-Hansen E, ed. Chicago: Quintessence 1985: 187-191
  • 32 Mikkonen P, Lindqvist C, Pihakari A. Osteotomy-osteosynthesis in displaced condylar fractures.  Int J Oral Maxillofac Surg . 1989;  18 267
  • 33 Takenoshita Y, Oka M, Tashiro H. Surgical treatment of fractures of the mandibular condylar neck.  J Cranio-Max-Fac Surg . 1989;  17 119
  • 34 Iizuka T, Lindqvist C, Hallikainen D. Severe bone resorption and osteoarthritis after miniplate fixation of high condylar fracture.  Oral Surg . 1991;  72 400
  • 35 Klotch D W, Lundy L B. Condylar neck fractures of the mandible.  Otolarygol Clin N Amer . 1991;  24 181
  • 36 Konstantinovic V S, Dimitrijevic B. Surgical versus conservative treatment of unilateral condylar process fractures: clinical and radiographic evaluation of 80 patients.  J Oral Maxillofac Surg . 1992;  50 439
  • 37 Krenkel C. Axial "anchor" screw (lag screw with biconcave washer) or "slanted-screw" plate for osteosynthesis of fractures of the mandibular condylar process.  J Cranio-Max-Fac Surg . 1992;  20 348
  • 38 MacArthur C J, Donald P J, Knowles J. Open reduction-fixation of mandibular subcondylar fractures.  Arch Otolaryngol Head Neck Surg . 1993;  119 403
  • 39 Eckelt U, Rasse M. Clinical, radiographic, and axiographic control after traction screw osteosynthesis of fractures of the mandibular condyle region.  Rev Stomatol Chir Maxillofac . 1995;  96 158
  • 40 Kallela I, Söderholm A-L, Paukku P. Lag-screw osteosynthesis of mandibular condyle fractures: a clinical and radiological study.  J Oral Maxillofac Surg . 1995;  53 1397
  • 41 Pereira M D, Marques A, Ishizuka M. Surgical treatment of the fractured and dislocated condylar process of the mandible.  J Cranio-Max-Fac Surg . 1995;  23 369
  • 42 Silvennoinen U, Iizuka T, Pernu H. Surgical treatment of condylar process fractures using axial anchor screw fixation: a preliminary follow-up study.  J Oral Maxillofac Surg . 1995;  53 884
  • 43 Chossegros C, Cheynet F, Blanc J-L. Short retromandibular approach of subcondylar fractures. Clinical and radiographic long-term evaluation.  Oral Surg . 1996;  82 248
  • 44 Dunaway D J, Trott J A. Open reduction and internal fixation of condylar fractures via an extended bicoronal approach with masseteric myotomy.  Br J Oral Maxillofac Surg . 1996;  49 79
  • 45 Widmark G, Bagenholm T, Kahnberg K E. Open reduction of subcondylar fractures. A study of functional rehabilitation.  Int J Oral Maxillofac Surg . 1996;  25 107
  • 46 Rodriguez E D, Adamo A K, Anastassov G E. Open reduction of subcondylar fractures via an anterior parotid approach.  J Cranio-Maxillofacial Trauma . 1997;  3 28
  • 47 Hammer B, Schier P, Prein J. Osteosynthesis of condylar neck fractures: a review of 30 patients.  Br J Oral Maxillofac Surg . 1997;  35 288
  • 48 Ellis E, McFadden D, Simon P, Throckmorton G S. Surgical complications with open treatment of mandibular condylar process fractures.  J Oral Maxillofac Surg . 2000;  58 950
  • 49 Ellis E, Tharanon W. Facial width problems associated with rigid fixation of mandibular fractures.  J Oral Maxillofac Surg . 1992;  50 87