Catching condyle – Endoscopic-assisted transoral open reduction and rigid fixation of condylar process fractures using an auto reposition and fixation osteosynthesis plate

Abstract

IntroductionFractures of the mandibular condyle are reported to account for 9 %–45 % of all mandibular fractures. There has been a long lasting controversy on the superiority of different treatment options with endoscopic-assisted transoral approaches gaining increasing attention in recent years. In this article, we report the application of a newly developed osteosynthesis plate for an auto reposition, reconstruction and rigid fixation of condylar process fractures. Material and methodsWe present 6 cases of uni- or bilateral fractures of the condylar process treated with a transoral open reduction and rigid fixation using an auto reposition plate. Via a transoral endoscopic assisted approach the proximal condyle fragment is captured using an anatomical defined clinch of the cranial part of the plate. The reposition of the condyle is facilitated with the distal bridge of the plate ranging around the posterior part of the ascending ramus. ResultsThe results show a sufficient reposition, rigid fixation and no facial nerve palsy or postoperative long-term occlusal disturbances. The mean operating time was 86 min. ConclusionTransoral endoscopic-assisted surgery with application of an auto reposition, reconstruction and fixation plate offers a quick and convenient way for open reconstruction and rigid fixation of condylar process fractures.