Transoral osteosynthesis of condylar neck fractures using a new three-dimensional osteosynthesis plate design G. Lauer, W. Pradel, M. Schneider, U. Eckelt
Mund Kiefer GesichtsChir 2006: 7: 335–340 A trans-oral approach for osteosynthesis of the condylar neck fractures can minimize the risk of damaging the facial nerve. However, stable osteosynthesis with two miniplates at the proximal fragment is often not feasible. In order to achieve a stable fixation of condylar neck fractures, a new delta-shaped osteosynthesis plate was developed by the authors and evaluated in this study. A total of 11 patients suffered from 13 condylar neck fractures (Spiessl I: n = 2, Spiessl II: n = 10, Spiessl III: n = 1 and 3 bilateral fractures) were treated through a transoral approach and assessed clinically and radiologically during the follow-up period. Functional parameters and fracture alignment were assessed. Functions returned to normal with a mouth opening of 42 mm with protrusion and laterotrusion of more than 5 mm 6 months post-operatively. Post-operative radiographic controls showed good fracture alignment in 7 of the 8 patients immediate post-operatively and in 6 of the 8 cases after 6 months. In 12 of the 13 fractures immediate post-operatively and 10 of the 13 fractures 6 months post-operatively, Towne’s radiographs showed an anatomical correct position. Neither plate fracture nor bending of the osteosynthesis plates was observed. Loosening of screws was found in 2 patients during plate removal. The authors concluded that the newly developed three-dimensional osteosynthesis plate was easy to handle and offered a sufficiently stable osteosynthesis of condylar neck fractures. Therefore, they recommended that delta-shaped osteosynthesis plate was a good choice for surgical fracture treatment of condylar neck fractures through a transoral approach.