Franz Haerle, Uwe Eckelt, Klaus Louis Gerlach, Guenter Lauer, Tateyuki Iizuka, Andreas Neff, Michael Rasse, Christian Krenkel, Juergen Reuther, and Christophe Meyer

As with the treatment of mandibular body fractures, the surgeon has two options for the treatment of condylar base (Loukota et al., 2005) and neck fractures: the closed and open treatments.

Conservative treatment is based on a centuries-old tradition, the first scientific publications having appeared more than 200 years ago (Desault, 1798; Malgaigne, 1847), whereas the open reduction has a relatively short history of just over than 80 years. The first report about an open reduction was published by Perthes in 1924; since then a continous development of open reduction procedures has taken place, whereas the modalities of closed treatment were largely exhausted in the mid-1930s by the introduction of functional treatment (Reichenbach, 1938). The introduction of functional treatmant affects the surgical approaches to the joint as well the techniques of reposition and osteosynthesis.

Up until the 1950s the osteosynthesis techniques were dominated by wire suturing, which is an unstable osteo-synthesis technique. Subsequently, more and more reports about more rigid osteosynthesis techniques were published, for example wire suturing combined with an extraoral pin fixation (Thoma, 1954) or with an intramedullary nail (Cadenat and Cadenat, 1956). However, these treatment methods did not enable an immediate mobilization of the mandible after surgery. That was only possible after the introduction of function-stable osteosynthesis procedures for different indications, including the condylar neck, for example, by miniplate (Robinson and Yoon, 1960; Snell and Dott, 1969; Pape et al., 1980) and by lag screw (Petzel, 1980; Eckelt, 1981; Krenkel, 1992). Function-stable osteosynthesis enabled, for the first time, both basic demands of condylar neck fracture treatment to be met simultaneously, that is, the exact anatomical repositioning of the fragments and the immediate mobilization of the joint in order to restore functionality. Advancement in X-ray imaging methods like computed tomography enabled an improved preoperative evaluation of the position of the fragments, which led to a more accurate indication. Nowadays, computed tomography in addition to orthopantomography are required in diagnosis of possible temporomandibular joint fractures—even, for example, diacapitular fractures.