Management of Condylar Process Fractures

Some issues related to management of fractures of the condylar process remain unsettled. In certain areas, however, there is consensus. In the child, with few exceptions, closed treatment is preferable, fixation periods should be short, a vigorous postfixation exercise program is essential, and patients should have long-term follow-up. In the adult, it is important to restore ramus height by an open reduction when (1) there are bilateral fractures without contact of the segments, (2) there is a unilateral fracture in an edentulous patient, or (3) there is a unilateral fracture in a dentulous patient with an unstable occlusion. Open reduction is also necessary when there is a need to establish a stable mandibular base for the treatment of associated midface fractures or when there is mechanical interference with establishing a proper occlusion.