Surgical Management of Mandibular Condylar Fractures

Fractures of the mandibular condyle present unique challenges owing to their deep anatomical location, proximity to the facial nerve and the critical need to restore dental occlusion. Surgical intervention is generally indicated for displaced condylar head and neck fractures, significant loss of ramus height or malocclusion that cannot be corrected conservatively. Common access routes include pre-auricular, retromandibular, submandibular and retro-auricular approaches, each chosen to balance optimal exposure with minimal risk to neurovascular structures. Internal fixation employs titanium plates and screws, whose configuration and geometry determine the stability of the reconstruction. Advances in three-dimensional imaging and computer-assisted planning have enabled bespoke implant designs and precise screw trajectories. Postoperative management emphasises early mobilisation of the temporomandibular joint and structured physiotherapy to prevent stiffness and ankylosis. Although regional variations in practice persist, there is broad agreement that open reduction and internal fixation delivers superior long-term functional outcomes in appropriately selected cases, reducing the incidence of chronic malocclusion, joint dysfunction and facial asymmetry.

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Surgical Management of Mandibular Condylar Fractures publication trend

The graph below shows the total number of articles in surgical management of mandibular condylar fractures across all publications each year (not limited to Nature Index journals).

Technical terms

Open reduction and internal fixation (ORIF): A surgical procedure that realigns bone fragments to their normal anatomical position and secures them with internal metal hardware.

Condylar neck fracture: A break occurring in the narrowed region of the mandible just below the condylar head, often requiring precise access for fixation.

Finite element analysis (FEA): A computational modelling technique used to simulate mechanical behaviour of bone and implants under physiological loads.

Retro-auricular approach: A surgical access route behind the ear enabling direct visualisation and fixation of condylar head fractures while preserving the facial nerve.

Osteosynthesis plate: A preformed or custom metal plate applied to fractured bone segments to maintain stability during healing.

References

1. Single versus Double Plate Fixation in Condylar Neck Fractures: Clinical Results and Biomechanics Simulation. Bioengineering (2024).
2. Biomechanical evaluation of type p condylar head osteosynthesis using conventional small-fragment screws reinforced by a patient specific two-component plate. Head & Face Medicine (2020).
3. Retro-Auricular Approach to the Fractures of the Mandibular Condyle: A Systematic Review. Journal of Clinical Medicine (2021).