Computer-assisted preoperative simulation for screw fixation of fractures of the condylar head.

w d f ractures of the condylar head are generally treated conseratively because exposure and fixation are difficult without amaging the facial nerve. Conservative treatment is also recmmended for children or for patients whose condylar head s in several fragments.1 The conservative approach requires ong-term treatment, whereas open surgery can provide early ecovery of occlusion and movement of the jaw for adults ho have a condylar fracture with a large segment and loss f the vertical height of the mandibular ramus.1–4 Preoperaive evaluation by three-dimensional computed tomography CT) with computerised simulation can help the surgeon to ecide whether open treatment is possible to fix the fracure. We have used three-dimensional simulation to assist n the planning and treatment of fractures of the condylar ead. Patients with maxillofacial fractures routinely have both hree-dimensional CT and conventional radiography. When he CT shows a fracture of the condylar head, and the ize of the fragment is large enough to fix with a plate, r screws, or both, digital imaging and communication in edicine (DICOM) data from the CT are put into Mimcs 14.01 software (Materialise, Leuven, Belgium) to enable omputer-assisted preoperative simulation. The mandible nd fragments from the condylar fracture are segmented ith the simulation software (Fig. 1), which enables the ragment from the condylar fracture to be virtually reduced n a precise fashion (Fig. 2). After the virtual reduction,