title: Clinical experience with osteosynthesis of subcondylar fractures of the mandible using TCP plates.
abstract: OBJECTIVE
  To evaluate the clinical and radiological results obtained with a new kind of osteosynthesis device (Modus TCP) plates, Medartis, Basel, Switzerland), especially designed for low subcondylar fracture (LSCF) and high subcondylar fracture (HSCF) of the mandible in association with the high submandibular approach (HSMA).
  
  
  METHODS
  A prospective clinical and radiological study was carried out over a 41-month period. All adult patients suffering from a displaced LSCF or HSCF who consented to the surgical treatment were included in the study. All fractures were operated on using an HSMA and were stabilised using a 4- or 9-hole TCP((R)) plate. No intermaxillary fixation was used and a soft diet was started on the 1st postoperative day. Clinical examinations and control X-rays were carried out on the 10th postoperative day, in the 1st, the 3rd and, at least, in the 6th postoperative months.
  
  
  METHODS
  Sixty-four patients (12 females, 52 males - mean age: 28.3) with a total of 75 fractures (54 LSCF, 21 HSCF) were included in the study. Mean postoperative follow-up was 14 months.
  
  
  RESULTS
  In the 6th postoperative month, all fractures were consolidated in 79% of the cases in an anatomical position. A secondary displacement of the fracture occurred in 6.6% of the cases. Plate fracture was not observed. Dental occlusion remained unchanged in 94% of the patients. The mandibular movements (mouth opening, protrusion, lateral movements on the unfractured and fractured side) had normal mean values (49.5, 10.4, 12.8, 12.1mm, respectively). These movements were symmetrical in 95% of the patients. No patient complained about articular pain or noise. No facial nerve palsy was noticed, not even a transiently one. All patients but one found the scars acceptable.
  
  
  CONCLUSIONS
  TCP plates, in association with HSMA, were found to be an efficient osteosynthesis device for stabilising subcondylar fractures.
authors.affiliation: Department of Oral and Maxillofacial Surgery , University Hospital of Besançon, France. christophe.meyer@chu-besancon.fr
authors.forename: Christophe
authors.initials: C
authors.lastname: Meyer
authors.forename: Simone
authors.initials: S
authors.lastname: Zink
authors.forename: Brice
authors.initials: B
authors.lastname: Chatelain
authors.forename: Astrid
authors.initials: A
authors.lastname: Wilk
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001860:Bone Plates; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008337:Mandibular Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D014025:Titanium
chemical_list: D014025:Titanium