A new non-endoscopic intraoral approach for open reduction and internal fixation of subcondylar fractures of the mandible.

Open reduction and internal fixation (ORIF) of subcondylar fractures of the mandible is a widely accepted treatment concept aimed at reconstruction of the vertical height of the mandibular ramus and restoration of occlusion. Here, we describe new instruments designed for ORIF via an intraoral approach using a single inverted y-miniplate. The special design allows sufficient visualisation of the fracture site and enables the establishment of a standardised procedure for the treatment of both dislocated and non-dislocated fractures. Several manoeuvres are described and some clinical cases are presented. Challenges frequently met during ORIF of subcondylar fractures via the intraoral approach such as limited exposure and visual control of fracture site can be overcome using the instruments-kit presented, which help to optimise this treatment.