Patient-Specific Devices for Surgical Treatment of Mandibular Condylar Head Fractures: Case Series of Early Experiences and Pitfalls.

Abstract

Open reduction and internal fixation (ORIF) of condylar head fractures (CHF) can be challenging. Virtual planning and CAD/CAM-based patient-specific devices (PSD) offer to enhance the accuracy of fragment reduction. We present four CHF cases demonstrating the strengths and shortcomings of different PSD designs. From this still limited experience, some fundamental recommendations evolved: • The PSD design should permit adequate visualization of the fracture line to ensure anatomical fracture reduction. • The PSD for reposition and prefixation of the medial fragment should incorporate an abundance of screw holes, particularly in its lateral section, since this part is most easily accessible intraoperatively. • PSDs extended over the dome of the condylar head should be omitted to avoid interferences between fragments, PSD and the adjacent glenoid fossa.