title: A new 3-dimensional plate for transoral endoscopic-assisted osteosynthesis of condylar neck fractures.
abstract: OBJECTIVE
  Transoral surgical treatment of condylar neck fractures minimizes the risk of damaging the facial nerve. But fracture reduction and plate osteosynthesis remain challenging, especially when using 2 plates, although endoscopic assistance has proven helpful. To further improve and simplify osteosynthesis at the condylar neck, a new delta-shaped osteosynthesis plate that mimics the function of 2 plates has been developed. The present clinical follow-up study was conducted to evaluate this new plate.
  
  
  METHODS
  A total of 16 patients with 19 condylar neck fractures (3 Spiessl I, 13 Spiessl II, 1 Spiessl III, 2 Spiessl IV) and 3 bilateral fractures were treated through an endoscopic-assisted transoral approach. After reduction, the plate was applied, with the screws inserted either transcutaneously or with angulated instruments.
  
  
  RESULTS
  The operation time ranged between 55 and 120 minutes. More than 6 months after the operation, functional parameters returned to normal, with an average mouth opening of 41 mm, protrusion of 5 mm, and laterotrusion of 6 mm. Radiographic controls showed good fracture alignment in 15 of 19 cases immediately after the operation, and in 14 of 19 cases 6 months after the operation. No plate fracture or bending was observed. In 3 patients, loose screws were found on plate removal.
  
  
  CONCLUSIONS
  The clinical data and the engineering and biomechanical background suggest that the new delta-shaped plate can be regarded as 2 miniplates. The new plate is suitable for treatment of condylar neck fractures, particularly when used in an endoscopic-assisted transoral approach.
authors: Department of Oral and Maxillofacial Surgery, University Hospital Carl Gustav Carus, Technical University, Dresden, Germany. guenter.lauer@uniklinikum-dresden.de
authors: Günter
authors: G
authors: Lauer
authors: Winnie
authors: W
authors: Pradel
authors: Matthias
authors: M
authors: Schneider
authors: Uwe
authors: U
authors: Eckelt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D001860:Bone Plates; D004724:Endoscopy; D004867:Equipment Design; D005260:Female; D020342:Finite Element Analysis; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008297:Male; D008335:Mandibular Condyle / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D008337:Mandibular Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D019647:Oral Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D011862:Radiography, Panoramic; D014025:Titanium; D016896:Treatment Outcome
chemical_list: D014025:Titanium