Long-term results of functional treatment of condylar fractures with the long bridle according to A. Rehrmann.

Long-term results in 23 cases with condylar fractures are presented. The method of treatment consisted in forward extension of the mandible by means of a long rubber bridle stretched between a steel hook at the chin and a strong sagittal wave-like, bent wire incorporated in a head cap. Strength and direction of the bridle can be modified. It provieds perfect repositioning of the mandible and a normal occlusion within some hours. The idea of this functional method is to eliminate the displacing muscular pull and dorsally-directed deviation of the mandible, and to restore muscular balance even with full range of mouth-opening. The distraction of the mandible from the glenoid fossa creates space and enables the dislocated condyles to upright themselves spontaneously. In cases of intracapsular or subcondylar fracture the active movements of the mandible, under the conditions of equilibrium, lead to a remodelling of the damaged condylar heads to a new form, induced by function. Ankylosis is avoided with certainty. Mandibular splinting or osteosynthesis are needed only in concomitant fractures of the rest of the mandible. The temporo-mandibular joint area and the rest of the mandible are considered to be independant entities in the treatment of condylar fractures. The method described is simple. Full mandibular mobility was obtained in all cases and spontaneous uprighting of dislocated condyles observed. There was no need for subsequent opening exercises.