Position paper from the IBRA Symposium on Surgery of the Head – The 2nd International Symposium for Condylar Fracture Osteosynthesis, Marseille, France 2012

Abstract

The experts and participating surgeons had comparable opinion on management of condylar fractures and complications of ORIF. Compared to the first Condylar Fracture Symposium 2007 in Strasbourg, ORIF may now be considered as the gold standard for both condylar base and neck fractures with displacement and dislocation. Although ORIF in condylar head fractures in adults and condylar fractures in children with mixed dentition is highly recommended, but this recommendation requires further investigations.

Surgical treatment of condylar head fractures, the way to minimize the postraumatic TMJ ankylosis

“…The treatment of CHFs (intracapsular, diacapitular, sagittal fractures) has been debated over recent years, and indications for open reduction and internal fi xation compared with closed reduction remain controversial (3,9,15,20,21). Non-surgical methods are widely accepted for treating children with sagittal condylar fractures but no consensus has been established for adult patients.…”

“…In condylar head fractures, specially at type B, C of the Neff classifi cation (17,20) the traction of lateral pterygoid muscle dislocates the fragment anteromedially and inferiorly sometimes resulting in shortening of the posterior ramal vertical height. This may cause restriction of the mandibular movement and malocclusion.…”

Open reduction and internal fixation of severely dislocated fractures of condylar neck and base using bioabsorbable miniplate in children: A 3–10 years follow-up study

“…The 2nd International [18]. The goal of this IBRA symposium was to evaluate current trends and potential changes of treatment strategies for mandibular condylar fractures, which remain controversial over the past decades.…”

“…Usually non-surgical treatment should be the first choice for children <6 years of age [18], But in our study population, two patients (<6 years of age) ( Table 1, patient 2 and patient 4) were with crown fracture of some deciduous molar and with dislocation of 1-2 teeth in the fracture line; patient 2 (aged 3 years old) with the comminuted fractures of parasymphysis, so we treated these children with ORIF using bioabsorbable miniplates in the condylar neck through a preauricular approach and in mandibular parasymphysis through an oral vestibular approach.…”

“…The aim of a closed treatment is to stimulate and eventually guide an appropriate remodeling of the condylar process, that is quite easily and appropriately obtained in children [18], but sometimes, some of children are harder to cooperate with closed treatment, such as intermaxillary elastic traction or maxillomandibular fixation (MMF).…”