Osteosynthesis of condylar neck fractures: a review of 30 patients

This article reviews 31 condylar neck fractures in 30 patients stabilized with different types of plates with emphasis on complications associated with different types of plates. Indications for stabilization were predominantly bilateral fractures, shortening of the ascending ramus due to lack of occlusal buttressing and condylar neck fractures associated with panfacial fractures. Stabilization was achieved with a single (23 fractures) or a double adaptation miniplate (4 fractures), a 2.4 mm plate (2 fractures) or a TMJ prosthesis (2 fractures). Eight fractures exhibited complications requiring reoperation (4 plate fractures, 3 cases of screw loosening associated with infection, 1 malposition). Complications occurred exclusively in the fractures stabilized with a single adaptation miniplate. Recommendations for stabilization, therefore, include a double miniplate, a 2.4 plate, a minidynamic compression plate (finger-plate) or a 2.0 mandibular-miniplate. Screws are preferably placed bicortically.