title: Update on mandibular condylar fracture management.
abstract: OBJECTIVE
  Fractures of the mandibular condyle have provided a lasting source of controversy in the field of facial trauma. Concerns regarding facial nerve injury as well as reasonable functional outcomes with closed management led to a reluctance to treat with an open operative intervention. This article reviews how incorporating new technologies and surgical methods have changed the treatment paradigm.
  
  
  RESULTS
  Multiple large studies and meta-analyses continue to demonstrate superior outcomes for condylar fractures when managed surgically. Innovations, including endoscopic techniques, three-dimensional miniplates, and angled drills provide increased options in the treatment of condylar fractures. The literature on pediatric condylar fractures is limited and continues to favor a more conservative approach.
  
  
  CONCLUSIONS
  There continues to be mounting evidence in radiographic, quality of life, and functional outcome studies to support open reduction with internal fixation for the treatment of condylar fractures in patients with malocclusion, significant displacement, or dislocation of the temporomandibular joint. The utilization of three-dimensional trapezoidal miniplates has shown improved outcomes and theoretically enhanced biomechanical properties when compared with traditional fixation with single or double miniplates. Endoscopic-assisted techniques can decrease surgical morbidity, but are technically challenging, require skilled assistants, and utilize specialized equipment.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University of Florida, Gainesville, Florida, USA.
authors.forename: Joshua P
authors.initials: JP
authors.lastname: Weiss
authors.forename: Raja
authors.initials: R
authors.lastname: Sawhney
mesh_terms: D000367:Age Factors; D004724:Endoscopy; D005592:Fracture Fixation; D006801:Humans; D016268:Internal Fixators; D008335:Mandibular Condyle / Q000293:injuries; D008337:Mandibular Fractures / Q000601:surgery*; D018579:Patient Selection