Transosseous wiring in the treatment of condylar fractures of the mandible.

During 1973-1975, 27 patients with condylar fractures at the lower or middle level were operated on via the submandibular approach; 5 patients were under 14 years of age. The condyles were medially dislocated or severely displaced, leading to malocclusion. Various kinds of transosseous wirings were used and the mean time of intermaxillary fixation was 22.6 days. The follow-up study of the 27 patients was made on average 11.6 months after the operation. Postoperatively the mouth opening averaged 41.5 mm. There was a slight deviation of the chin (mean 2mm) to the operated side in half the cases. Lateral excursions were within normal limits. Slight motor weakness in the lower lip on the operated side was noted in 3 cases and mild pain in the operated joint in 8 cases. A radiograph revealed some shortening of the condyle in most cases, and some kind of angulation, mostly posterior, in half the cases. No tendency to ankylosis was found and totally normal and symmetric function of the joints was noted in 24 cases. In the light of the results of this follow-up study the method presented, which is not a very easy one, seems to be useful.