**5. Clinical examination**

*Oral and Maxillofacial Surgery*

**4.5 The AO 2010**

Based on:

line.

**4.6 Neff 2014**

below [6].

condylar head.

inferiorly [7].

and disc displacement:

of the ramus

ment [8]

**4.7 Ying 2017**

behind the mandibular foramen

tion of the sigmoid notch.

dicular to the first line.

Based on the disc and condylar head:

overlap by the bony edges or both [6]

• Condylar base: more than half of the fracture line is below line A originating

• Minimal displacement: less than 10 mm of displacement or less than 2 mm of

• The sigmoid notch line runs perpendicular to the first line at the deepest por-

• There is a line below the lateral pole of the condylar head that is also perpen-

• A line is drawn half way between the lateral pole line and the sigmoid notch

• A "high-neck" fracture is above this line, whereas a "low-neck" fracture is

• Condylar head: the condylar head reference line runs perpendicular to the

• Condylar neck: the sigmoid notch line running through the deepest point of the sigmoid notch perpendicular to the ramus line extending superiorly to the

• Base of the condylar process: the sigmoid notch line running through the deepest point of the sigmoid notch perpendicular to the ramus line extending

Classification of condylar head fracture based on vertical height of the ramus

• Type B—disc displacement without decrease in vertical height of the ramus

• Type C—decrease in vertical height of the ramus with/without disc displace-

posterior ramus below the lateral pole of the condylar head.

• Type A— no disc displacement or decrease in vertical height

• The first line parallels the posterior border of the mandible.

**124**

Condyle fractures are diagnosed with the help of both clinical and radiological assessment. Condylar fractures are most commonly missed on clinical examination. Extracapsular condylar fractures are frequent and may be associated with displacement of the condylar head. The condylar head may be in contact with the ramus or can be displaced laterally or medially. Anteromedial displacement is more common due to the pull of lateral pterygoid and weak medial capsule.
