[Indications for various reconstruction and osteosynthesis methods in surgical management of subcondylar fractures of the mandible].

Abstract

We do not advocate routine open reduction in subcondylar fractures, but there are some indications for surgical treatments. If we have decided for open reduction, the risks must be weighed against the benefits. If we are not sure, that the condyle is in a correct position, we avoid rigid internal fixation and we prefer only a temporary stabilization with resorbable Polydioxanone, Polylactide or autologous bone-pins. In non oblique fractures, we recommend only open reduction without further internal fixation. The advantage is that the condyle has the ability to move into a physiologic position and there is no need to remove metal implants in a second operation, the disadvantage is that we cannot avoid MMF and functional therapy, but our experience shows that the functional therapy can be shortened. Resorbable- and bone-pins could not take place of miniplates or traction-screws, but in selected cases, they could enlarge the surgical treatment in subcondylar fractures.