[Surgical reposition and fixation of mandibular condyle fractures via intraoral approach]

In a case series 54 patients with 61 subcondylar fractures had been treated by surgical repositioning and miniplate-fixation by an intraoral approach. Functional results with special regard to the function of the temporomandibular joint TMJ were registered not earlier than 1 year postoperatively and compared to a case series of 48 patients with 63 conservatively treated subcondylar fractures. Axiographic or pantographic investigation proved higher incidence of TMJ-disorders as it was the case for the common clinical functional examination. TMJ-function was worse in the conservatively treated cases especially in dislocated fractures. Therefore dislocated fractures especially with luxation of the TMJ should be surgically treated. Surgical repositioning and fixation by an intraoral approach is difficult and allows only limited access and view of the fracture, but avoids complications by scaring or facial nerve damage and seems to be sufficient for adequate repositioning. Minor dislocations showed no influence on TMJ-function. Of course surgical repair of disrupted TMJ-ligaments is not possible by an intraoral approach-disrupted TMJ-ligaments in luxated joints seem to be of major importance for the later TMJ-function.