Journal of Oral and Maxillofacial Surgery
Volume 66, Issue 8 , Pages 1586-1594 , August 2008

Closed Versus Open Operative Treatment of Nondisplaced Diacapitular (Class VI) Fractures

  • Constantin A. Landes, MD, DMD, PhD

      Affiliations

    • Assistant Professor, Maxillofacial and Plastic-Facial Surgery, The Frankfurt University Medical Center, Frankfurt, Germany.
    • Corresponding Author InformationAddress correspondence and reprint requests to Dr Landes: Maxillofacial and Plastic-Facial Surgery, Frankfurt University Medical Center, Theodor-Stern-Kai 7, 60596 Frankfurt, Germany
    • ,
  • Kai Day, DMD

      Affiliations

    • Research Fellow, Maxillofacial and Plastic-Facial Surgery, The Frankfurt University Medical Center, Frankfurt, Germany.
    • ,
  • Ruben Lipphardt, MD

      Affiliations

    • Research Fellow, Maxillofacial and Plastic-Facial Surgery, The Frankfurt University Medical Center, Frankfurt, Germany.
    • ,
  • Robert Sader, MD, DMD, PhD

      Affiliations

    • Professor and Chairman, Maxillofacial and Plastic-Facial Surgery, The Frankfurt University Medical Center, Frankfurt, Germany.

References 

  1. Baker AW, McMahon J, Moos KF. Current consensus on the management of fractures of the mandibular condyle (A method by questionnaire). Int J Oral Maxillofac Surg. 1998;27:258
  2. Banks P. A pragmatic approach to the management of condylar fractures. Int J Oral Maxillofac Surg. 1998;27:244
  3. Duan DH, Zhang Y. A meta-analysis of condylar fracture treatment. [in Chinese] Zhonghua Kou Qiang Yi Xue Za Zhi. 2006;41:388
  4. Hlawitschka M, Loukota R, Eckelt U. Functional and radiological results of open and closed treatment of intracapsular (diacapitular) condylar fractures of the mandible. Int J Oral Maxillofac Surg. 2005;34:597
  5. Neff A, Kolk A, Neff F, et al. Operative versus conservative therapy of condylar head and high condylar fractures. Mund Kiefer Gesichtschir. 2002;6:66
  6. Rasse M. New developments in the therapy for condylar fractures of the mandible. Mund Kiefer Gesichtschir. 2000;4:69
  7. Stiesch-Scholz M, Schmidt S, Eckardt A. Condylar motion after open and closed treatment of mandibular condylar fractures. J Oral Maxillofac Surg. 2005;63:1304
  8. Spiessl B, Schroll K. Gelenkfortsatz und kieferköpfchenfrakturen. In:  Nigst H editors. Spezielle Frakturen- und Luxationslehre. Vol 1:Gesichtsschädel, Stuttgart-New York: Thieme; 1972;p. 136
  9. Eckelt U, Schneider M, Erasmus F, et al. Open versus closed treatment of fractures of the mandibular condylar process—A prospective randomized multi-centre study. J Craniomaxillofac Surg. 2006;34:306
  10. Neff A, Kolk A, Horch HH. Position and mobility of the articular disk after surgical management of diacapitular and high condylar dislocation fractures of the temporomandibular joint. [in German] Mund Kiefer Gesichtschir. 2000;4:111
  11. Choi BH. Magnetic resonance imaging of the temporomandibular joint after functional treatment of bilateral condylar fractures. Int J Oral Maxillofac Surg. 1997;26:344
  12. Neff A, Kolk A, Deppe H, et al. New aspects for indications of surgical management of intra-articular and high temporomandibular dislocation fractures. [in German] Mund Kiefer Gesichtschir. 1999;3:24
  13. Walker RV. Condylar fractures: Non-surgical management. J Oral Maxillofac Surg. 1994;52:1185
  14. Hlawitschka M, Eckelt U. Assessment of patients treated for intracapsular fractures of the mandibular condyle by closed techniques. J Oral Maxillofac Surg. 2002;60:784
  15. Oezmen Y, Mischkowski RA, Lenzen J, et al. MRI examination of the TMJ and functional results after conservative and surgical treatment of mandibular condyle fractures. Int J Oral Maxillofac Surg. 1998;27:33
  16. Raveh J, Vuillemin T, Lädrach K. Open reduction of the dislocated, fractured condylar process: Indications and surgical procedures. J Oral Maxillofac Surg. 1989;47:120
  17. Silvennoinen U, Iizuka T, Pernu H, et al. Surgical treatment of condylar process fractures using axial anchor screw fixation: A preliminary follow-up study. J Oral Maxillofac Surg. 1995;53:884
  18. Choi BH, Kim KN, Kim HJ, et al. Evaluation of condylar neck fracture plating techniques. J Craniomaxillofac Surg. 1999;27:109
  19. Landes CA, Lipphardt R. Prospective evaluation of a practical treatment rationale: ORIF of dislocated and displaced condyle and condylar fractures and CR of non-displaced, non-dislocated fractures. Part I: Condyle and subcondylar fractures. Int J Oral Maxillofac Surg. 2005;34:859
  20. Landes CA, Lipphardt R. Prospective evaluation of a practical treatment rationale: ORIF of dislocated and displaced condyle and condylar fractures and CR of non-displaced, non-dislocated fractures. Part II: High condylar and dia-capitular fractures. Int J Oral Maxillofac Surg. 2006;35:115
  21. Neff A, Kolk A, Meschke F, et al. Small fragment screws vs. plate osteosynthesis in condylar head fractures. [in German] Mund Kiefer Gesichtschir. 2005;9:80
  22. Lund K. Mandibular growth and remodeling processes in the temporomandibular joint. Acta Odontol Scand. 1974;32:1
  23. Rasse M, Beck H, Futter M. Ergebnisse nach konservativer und operativer Versorgung von Gelenkfortsatzfrakturen des Unterkiefers. Z Stomatol. 1990;87:215
  24. Rasse M, Schober C, Piehslinger E, et al. Intra- und extrakapsuläre kondylusfrakturen im wachstumsalter (Therapie, verlauf, komplikationen). Dtsch Zahnärztl Z. 1991;46:49
  25. Thoren H, Hallikainen D, Iizuka T, et al. Condylar process fractures in children (A follow-up study of fractures with total dislocation of the condyle from the glenoid fossa). J Oral Maxillofac Surg. 2001;59:768
  26. Umstadt HE, Ellers M, Müller HH, et al. Functional reconstruction of the TM joint in cases of severely displaced fractures and fracture dislocation. J Cranio Maxillofac Surg. 2000;28:97
  27. Silvennoinen U, Raustia AM, Lindquist C, et al. Occlusal and temporomandibular joint disorders in patients with unilateral condylar fracture (A prospective study). Int J Oral Maxillofac Surg. 1998;27:280
  28. Al-Kayat A, Bramely P. A modified pre-auricular approach to the temporomandibular joint and malar arch. Br J Oral Surg. 1979;17:91
  29. Landes CA, Sader R. Sonographic norm ranges for condylar translation and joint space width in Class I, II, and III individuals (Comparison of non-symptomatic to symptomatic joints). J Craniomaxillofac Surg. 2008;(in press)
  30. Schimming R, Eckelt U, Kittner T. The value of coronal CT in fractures of the mandibular condylar process. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;87:632
  31. Takenoshita Y, Oka M, Tashiro H. Surgical treatment of fractures of the mandibular condylar neck. J Craniomaxillofac Surg. 1989;17:119
  32. Neff A, Muhlberger G, Karoglan M. Stability of osteosyntheses for condylar head fractures in the clinic and biomechanical simulation. [in German] Mund Kiefer Gesichtschir. 2004;8:63
  33. Landes CA, Seitz O, Rieger J, et al. First experiences with a new resorbable osteosynthesis material of high strength retention force and small size. J Craniomaxillofac Surg. 2006;34:18
  34. Throckmorton GS, Talwar RM, Ellis E. Changes in masticatory patterns after bilateral fracture of the mandibular condylar process. J Oral Maxillofac Surg. 1999;57:500
  35. Zimmer B, Jäger A, Kubein-Meesenburg D. Comparison of “normal” TMJ-function in Class I, II, and III individuals. Eur J Orthod. 1993;13:27
  36. Emshoff R, Jank S, Bertram S, et al. Disk displacement of the temporomandibular joint: Sonography versus MR imaging. AJR Am J Roentgenol. 2002;178:1557
  37. Landes C, Walendzik H, Klein C. Sonography of the temporomandibular joint from 60 examinations and comparison with MRI and axiography. J Craniomaxillofac Surg. 2000;28:352
  38. Palmieri C, Ellis E, Throckmorton G. Mandibular motion after closed and open treatment of unilateral mandibular condylar process fractures. J Oral Maxillofac Surg. 1999;57:764
  39. Rasse M. Diakapituläre frakturen der mandibula (Eine neue operationsmethode und erste ergebnisse). Z Stomatol. 1993;90:413
  40. Rasse M, Koch A, Traxler H, et al. Der frakturverlauf von diakapitulären frakturen der mandibula – eine klinische studie mit anatomischer korrelation. Z Stomatol. 1993;90:119
  41. Talwar RM, Ellis E, Throckmorton GS. Adaptations of the masticatory system after bilateral fractures of the mandibular condylar process. J Oral Maxillofac Surg. 1998;56:430

PII: S0278-2391(07)01535-2

doi: 10.1016/j.joms.2007.06.668

Journal of Oral and Maxillofacial Surgery
Volume 66, Issue 8 , Pages 1586-1594 , August 2008

Article Tools

* Image Usage & Resolution