Traumatology of the mandibular condylar process

The indications for closed or open treatment of fractures of the mandibular condylar process are a controversial subject. Closed treatment is currently predominant for pediatric fractures and for adults with minimally or non-displaced fractures. In contrast closed treatment in adults with displaced and dislocated fractures will usually show less favorable results. Currently, there is an increasing agreement that the indications for open reduction are displaced fractures and particularly in cases of dislocated and bilateral fractures. Open reduction and internal fixation are aimed at restoring correct anatomy and thus physiological joint function. At present surgeons should be able to use safe operative approaches for the different fracture levels (base, neck and condylar head), which allow the application of stable osteosynthesis methods especially designed for the individual fracture patterns. The challenge is therefore to choose the optimum treatment for the individual case, i.e. an efficient quick and as least traumatic as possible recovery of function.