Condylar fractures (CFs) comprise 40–70 % of pediatric mandibular fractures due to anatomical vulnerability (thinner cortex bone, thicker condylar neck) (Wolfswinkel et al., 2013; Boffano et al., 2015). While conservative treatment (e.g., intermaxillary fixation) is preferred for children given their remodeling capacity, it risks growth retardation, temporomandibular joint ankylosis (TMJA), etc. (Thoren et al., 2001; Glazer et al., 2011; Bruckmoser and Undt, 2012). Literature and our previous studies have shown that severely displaced fractures (angulation >45° or ramus height loss >4 mm) and some “dangerous” fractures such as the stump of the ramus is contact or displaced out of the fossa are easy to cause these complications. These are relative and absolute indications for surgical treatment (Schneider et al., 2008; Singh et al., 2010; He et al., 2014). But for pediatric CFs with soft and small bone fragments, open reduction and internal fixation (ORIF) is difficult and may destroy the growth potential.

Although there are few studies on surgical treatment (Bos et al., 1999), Rasse (Rasse et al., 1991) pioneered ORIF for ICFs, emphasizing lateral pterygoid muscle preservation and stable osteosynthesis. Later Kermer (Kermer et al., 1998) and Meng (Meng et al., 2010) showed that atraumatic reduction and cartilage-sparing fixation reduce growth disturbances. We also emphasized disc reduction in ICF (Chen et al., 2010) and its role on the prevention of ankylosis (Li et al., 2015; He et al., 2016). By preserving cartilage, our previous study also showed growth potential after ORIF (Feng et al., 2012; He et al., 2013).

The aim of the study is to evaluate the follow-up results of ORIF with disc reduction techniques in pediatric condylar fractures by three-dimensional (3D) CT measurement.