British Journal of Oral and Maxillofacial Surgery 50 (2012) 470–473 Available online at www.sciencedirect.com Short communication Three-dimensional fixation of fractures of the mandibular condyle with a resorbable three-dimensional osteosynthesis mesh Matthias Schneider a,* , Bernd Stadlinger a , Richard Loukota b , Uwe Eckelt a a Department of Oral and Maxillofacial Surgery, University Hospitals Carl Gustav Carus, Technical University of Dresden, Germany b Department of Oral and Maxillofacial Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, UK Accepted 12 November 2011 Available online 6 December 2011 Abstract We describe the use of a resorbable mesh fixed by ultrasound-activated pins, and report the satisfactory outcome in the first 5 patients treated. © 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved. Keywords: Resorbable mesh; Resorbable pins; Ultrasound activated pins; Mandibular fracture; Condylar neck fracture Introduction The surgical treatment of mandibular condylar fractures is increasing worldwide. 1 Currently the insertion of titanium or steel plates and screws is the standard treatment for all types of condylar fracture. When metallic osteosynthesis materials are used, the plates and screws can loosen, 2 and removal of the osteosynthesis material endangers the facial nerve and can cause additional scars. The use of resorbable material is an alternative treatment of fractures of the mandibular condyle. However, these mate- rials are considerably less stable than titanium. An innovative approach is “bone welding” technology, 3 which has already been established as a treatment for midfacial fractures and in craniofacial surgery. It has been shown to be effective in * Corresponding author at: Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Universitätsklinikum “Carl Gustav Carus” der Technis- chen Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany. Tel.: +49 351 4583382; fax: +49 351 4585382. E-mail address: Matthias.Schneider@uniklinikum-dresden.de (M. Schneider). condylar fractures in vitro, in animal studies, and it has some clinical applications. 4,5 Materials and methods Moderately and considerably displaced fractures of the condylar base and neck are subject to considerable forces after surgical reduction. We describe the fixation of such fractures with a three-dimensional, individually moulded, ResorbX ® mesh (poly-d/l-lactide, material strength 1.0 mm, Fig. 1) to overcome these forces. We used an extraoral peri- angular approach. We treated fractures of the condylar neck with lateral displacement of the condylar fragment—these are the most straightforward to treat with a new technique. The mesh plate was initially heated in a waterbath and was pre- formed using a sterile, standard mandibular model. After the fracture had been reduced, the mesh was adapted to the bone fragments using specialised ultrasound SonicWelder ® adapters, and repeated partial contouring when it was in place. After the mesh had solidified the reduced fracture seemed stable. The adapted mesh (Fig. 2) was further fixed 0266-4356/$ – see front matter © 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.bjoms.2011.11.006