Objective. In a retrospective study, we reviewed a series of 55 consecutive
patients with 57 fractures of the condylar neck that were treated with tra
nsoral miniplate osteosynthesis.
Study design. Forty-one patients were included in a clinical follow-up stud
y; the median length of study was 26.5 months (minimum, 7 months; maximum,
79 months). In a radiographic study, the positions of the condyle before op
en reduction, after open reduction, and more than 6 months postoperatively
were evaluated in 3 radiographic planes. A statistical analysis was perform
ed to determine factors that lead to secondary instability of the reduced c
ondyle and to correlate the actual position of the condyle with clinical pa
rameters collected in follow-up examinations.
Results. At the time of the follow-up examination, the median measurement o
f the mandibular openings was 48.3 +/- 8.0 mm (minimum, 32 mm; maximum, 66
mm). A deviation of 2 mm to the operated side when opening was observed in
7 patients. The median range of laterotrusion was 10.0 mm to the fracture s
ide and 9.0 mm to the opposite side. In 7 patients, radiographic follow-up
more than 6 months postoperatively revealed a medial tilt of the proximal f
ragment of 15 to 40 degrees despite a good immediate postoperative position
of the condyle. This may be attributed to bone resorption in the fracture
gap, together with a bending instability observed when titanium miniplates
with a thickness of 0.9 mm were used. The position of the condyle at the fo
llow-up examination did not correlate with clinical parameters.
Conclusions. Transoral approach miniplate osteosynthesis of dislocated cond
ylar neck fractures is indicated when visible scars in the head and neck re
gion, which are encountered with other fixation techniques, must be avoided
.