Surgical Management of a Mandible Subcondylar Fracture

Open reduction and anatomic reduction can create better function for the temporomandibularjoint, compared with closed treatment in mandible fracture surgery. Therefore, the doubleminiplate fixation technique via mini-retromandibular incision was used in order to makethe most stable fixation when performing subcondylar fracture surgery. Those approachesprovide good visualization of the subcondyle from the posterior edge of the ramus, allow thesurgeon to work perpendicularly to the fracture, and enable direct fracture management.Understanding the biomechanical load in the fixation of subcondylar fractures is alsonecessary in order to optimize fixation methods. Therefore, we measured the biomechanicalloads of four different plate fixation techniques in the experimental model regardingmandibular subcondylar fractures. It was found that the loads measured in the two-platefixation group with one dynamic compression plate (DCP) and one adaption plate showed thehighest deformation and failure loads among the four fixation groups. The loads measuredin the one DCP plate fixation group showed higher deformation and failure loads than theloads measured in the two adaption plate fixation group. Therefore, we conclude that theselection of the high profile plate (DCP) is also important in order to create a stable load in thesubcondylar fracture.