British Journal of Oral and Maxillofacial Surgery (2005) 43, 72—73

SHORT COMMUNICATION

Subclassification of fractures of the condylar

process of the mandible
R.A. Loukotaa,∗, U. Eckeltb, L. De Bontc, M. Rassed

a Leeds Teaching Hospitals NHS Trust, Leeds, UK

b Universitätsklinkum Carl Gustav Carus der technischen Universität Dresden, Dresden, Germany
c Academisch Ziekenhuis Groningen, Groningen, The Netherlands
d Krankenhaus Wels, Wels, Austria

Accepted 20 August 2004

Available online 27 October 2004

KEYWORDS Summary We present the definitions of various types of fracture of the condylar
Condylar; process, which have been adopted for the Strasbourg Osteosynthesis Research Group
Fracture (SORG), in their Pan-European prospective randomised controlled trial into the man-
agement of such fractures. We think that this will assist people in their description
of the various types of fracture of the condylar process.
© 2004 The British Association of Oral and Maxillofacial Surgeons. Published by
Elsevier Ltd. All rights reserved.

Introduction some fractures as being ‘‘intracapsular’’ when they

There are numerous classifications of fractures of
the condylar process.1—3 Speissl and Schroll identi-
fied six types of fracture but, unless you are conver-
sant with this classification a Speissl & Schroll Type 5
fracture may not allow you to visualise immediately
the type of fracture being discussed. There are also
some differences in grammar across Europe, which
may also lead to some confusion with fractures
described as either dislocated (mainland Europe),
which is equivalent to displaced (USA and Great
Britain), and luxated (mainland Europe), which is
equivalent to dislocated (USA and Great Britain).
Another anomaly is the inaccurate description of
* Corresponding author. Tel.: +44 113 233 6219.
E-mail address: rloukota@doctors.org.uk (R.A. Loukota).
are often through the head of the condyle extend-
ing in a sagittal direction through the condylar head
but extending to the medial aspect of the condylar
neck in an extracapsular position.
We think that accurate anatomical description
will allow visualisation by most practitioners with-
out the need to memorise numerically ordered
types of fracture. We have adopted the USA/UK
nomenclature with regard to displacement and dis-
location and the mainland European description of
diacapitular fractures (through the condylar head).
We also think that a measured angle of displace-
ment (anteroposterior with or without mediolat-
eral) and the measured physical overlap will also
provide useful information to the surgeon. How-
ever, we think that particularly the subjective de-

0266-4356/$ — see front matter © 2004 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
doi:10.1016/j.bjoms.2004.08.018
Subclassification of fractures of the condylar process of the mandible 73

Figure 2. Fracture of the condylar neck.

Figure 1. Diacapitular fracture (through the head of the

condyle).

scriptions of ‘‘high’’ and ‘‘low’’ fractures should

be clarified. We suggest that the terms fracture of
the condylar neck and fracture of the condylar base
should be adopted, and we include our definitions.

Definitions

1. Diacapitular fracture (through the head of the

condyle): The fracture line starts in the articu-
lar surface and may extend outside the capsule.
(Fig. 1).
2. Fracture of the condylar neck: The fracture line
starts somewhere above line A and in more than
half runs above the line A in the lateral view
(Fig. 2). Line A is the perpendicular line through
the sigmoid notch to the tangent of the ramus.
3. Fracture of the condylar base: The fracture line
runs behind the mandibular foramen and, in
more than half, below line A (Fig. 3).
The term ‘‘minimal displacement’’ is taken to be
the definition that is used in the multicentre study—
–that is, displacement of less than 10◦ or overlap of
the bone ends of less than 2 mm, or both.
Figure 3. Fracture of the condylar base.
References
1. Spiessl B, Schroll K. Gelenkfortsatz und gelenkkopfchenfrac-
turen (Fractures of the condylar neck and head). In: Higst
H, editor. Spezielle frakture und luxationslehre (Textbook
of specialised fractures and dislocations) BD. I/I. Stuttgart:
Thieme; 1972.
2. MacLennan DW. Consideration of 180 cases of typical frac-
tures of the mandibular condylar process. Br J Plastic Surg
1952;5:122—8.
3. Lindahl L, Hollender L. Condylar fractures of the mandible. A
radiographic study of remodelling processes in the tempero-
mandibular joint. Int J Oral Surg 1977;6:153—65.