Advances in the Management of Mandibular Condylar Fractures v

Contents
Preface: Where Are the Advancements in the Management of Mandibular Condylar Process
Fractures? ix
Martin B. Steed

Classication of Mandibular Condylar Fractures 1

David B. Powers

Anatomy and Biomechanics of Condylar Fractures 11

Cameron J. Walker and Stephen P.R. MacLeod

Introduction 11
Overview of anatomy 11
Biomechanics of condylar fractures 14
Summary 15

Virtual Surgical Planning and Intraoperative Imaging in Management of Ballistic Facial and
Mandibular Condylar Injuries 17
Philipp Kupfer, Allen Cheng, Ashish Patel, Melissa Amundson, Eric J. Dierks, and R. Bryan Bell

Introduction 17
Surgical procedure 21
Summary 23

The Role of Intra-articular Surgery in the Management of Mandibular Condylar Head

Fractures 25
Paolo Boffano, Pierre Corre, and Stefano Righi

Introduction 25
Content 25
Imaging and surgical planning 26
Indications 27
Surgical approaches 27
Surgical techniques 28
Complications 33
Summary 33

The Biology of Open Versus Closed Treatment of Condylar Fractures 35

Susan K. Snyder and Larry L. Cunningham Jr

Vascular supply 35
Structural adaptations 37
Summary 45
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Secondary Treatment of Malocclusion/Malunion Secondary to Condylar Fractures 47

Glenn Maron, Amy Kuhmichel, and Geoffrey Schreiber

Splint therapy and physical therapy 47

Conservative treatment 48
Equilibration 48
Orthodontic correction of bilateral condylar process fractures 48
Arthroplasty/Total joint replacement 49
Orthodontics and orthognathic surgery 52
Case report 53
Treatment protocol 53
Summary 53

Matching Surgical Approach to Condylar Fracture Type 55

Hany A. Emam, Courtney A. Jatana, and Gregory M. Ness

Introduction 55
Identifying fractures by location 55
Surgical approaches 55
Submandibular/periangular 56
Retromandibular 56
Preauricular/endaural 58
Retroauricular 59
Transoral 60
Summary 61

Soft Tissue Trauma in the Temporomandibular Joint Region Associated with Condylar
Fractures 63
Deepak G. Krishnan

Introduction 63
Internal injuries to the temporomandibular joint 63
Penetrating soft tissue temporomandibular joint trauma 64
Hemarthrosis of the joint 64
Damage to the joint surfaces, disc, and disc displacement 64
Damage to the glenoid fossa 64
Changes to soft tissue injuries following repair of the fractures 65
Healing of soft tissue injuries in closed treatment of mandibular fractures 65
Healing of soft tissue injuries in open treatment of mandibular fractures 66
Summary 66

Plating Options for Fixation of Condylar Neck and Base Fractures 69

Eric L. Bischoff, Ryan Carmichael, and Likith V. Reddy

Introduction 69
Surgical approach 69
Biomechanics of the condylar neck and base 69
Plating options 70
Summary 73
 Contents vii

Management of Pediatric and Adolescent Condylar Fractures 75

Martin B. Steed and Caleb M. Schadel

Introduction 75
Craniofacial growth and development 75
Frequency of pediatric condylar fractures 76
Diagnosis 77
Closed versus open treatment 77
Uncommon injuries and complications 80
Summary 83