Endoscopic approach to subcondylar mandible fractures

Current interest in minimally invasive surgery has extended to the repair of craniomaxillofacial fractures, including subcondylar fractures of the mandible. Recent experience indicates that rigid fixation by the endoscopic approach is technically feasible, particularly for subcondylar fractures with lateral displacement of the proximal fragment. The technique is more difficult (although not impossible) for medially displaced fractures. High condylar fractures and comminuted fractures may not be amenable to this approach unless there is enough bone present to allow placement of screws in the proximal fragment. Because evidence suggests that the outcome of open reduction of subcondylar fractures may be better than the outcome when closed management is performed, techniques that minimize the morbidity of open reduction should allow better long-term results. It is hoped that the endoscopic approach for the repair of subcondylar fractures of the mandible will provide these benefits. The technique is summarized with step-by-step explanations.