Abstract
Purpose
To evaluate surgical complications associated with open reduction and internal fixation of condylar fractures using retromandibular approach in terms of intraoperative and postoperative complications.
Method
Ten patients with displaced unilateral/bilateral condylar fractures were selected for the study. Intraoperative complications were evaluated in the form of haemorrhage due to damage to retromandibular vein and damage to marginal mandibular branch of facial nerve. Postoperative complications like presence of infection, signs of Frey’s syndrome, parotid fistula formation, facial nerve palsy, and discrepancy in occlusion and functions of temporomandibular joint were evaluated at intervals of 24 h, one week, six weeks and three months postoperative. Radiographically, the approximation of fracture fragments, plate fracture and screw loosening on orthopantomograph and Reverse Towne’s view were evaluated at intervals of 24 h, six weeks and three months postoperatively.
Results
None of the patients suffered from any major complication intra and post operatively.
Conclusion
Open reduction and internal fixation should be given due consideration in the management of displaced mandibular condylar fractures and is associated with minimal morbidity using retromandibular approach.
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References
Ellis E 3rd, Dean J (1993) Rigid fixation of mandibular condyle fractures. Oral Surg Oral Med Oral Pathol. 76(1):6–15
Hyde N, Manisali M, Aghabeigi B, Sneddon K, Newman L (2002) The role of open reduction and internal fixation in unilateral fractures of the mandibular condyle: a prospective study. Br J Oral Maxillofac Surg 40(1):19–22
Blevins G, Gores RJ (1961) Fractures of the mandibular condyloid process: results of conservative treatment in 140 patients. J Oral Surg Anesth Hosp Dent Serv 19:28–30
Amaratunga NA (1987) A study of condylar fractures in Sri Lankan patients with special reference to the recent views on treatment, healing and sequelae. Br J Oral Maxillofac Surg 25(5):391–397
Zide MF, Kent JN (1983) Indications for open reduction of mandibular condyle fractures. J Oral Maxillofac Surg 41(2):89–98
Fernandez JA, Mathog RH (1987) Open treatment of condylar fractures with biphase technique. Arch Otolaryngol Head Neck Surg 113(3):262–266
Klatt J, Pohlenz P, Blessmann M, Blake F, Eichhorn W, Schmelzle R, Heiland M (2010) Clinical follow-up examination of surgically treated fractures of the condylar process using the transparotid approach. J Oral Maxillofac Surg. 68(3):611–617
Newman L (1998) A clinical evaluation of the long-term outcome of patients treated for bilateral fracture of the mandibular condyles. Br J Oral Maxillofac Surg 36(3):176–179
Lachner J, Clanton JT, Waite PD (1991) Open reduction and internal rigid fixation of subcondylar fractures via an intraoral approach. Oral Surg Oral Med Oral Pathol 71(3):257–261
Silverman SL (1925) New operation for displaced fractures at the neck of the condyle. Int J Orthod 67:876
Chossegros C, Cheynet F, Blanc JL, Bourezak Z (1996) Short retromandibular approach of subcondylar fractures. Clinical and radiologic long term evaluation. Oral Surg Oral Med Oral Pathol Oral Radiol, Oral Endod 82(3):248–252
Wu CY, Shi XJ, Li Y (2004) Retromandibular incision, miniplate rigid fixation for condylar, subcondylar fractures. Shanghai Kou Qiang Yi Xue 13(1):20–22
Narayanan V, Kannan R, Sreekumar K (2009) Retromandibular approach for reduction and fixation of mandibular condylar fractures: a clinical experience. Int J Oral Maxillofac Surg 38(8):835–839
Ellis E, Throckmorton G, Palmieri C (2000) Open treatment of condylar process fractures: assessment of adequacy of repositioning and maintenance of stability. J Oral Maxillofac Surg 58(1):27–34
Downie JJ, Devlin MF, Carton AT, Hislop WS (2009) Prospective study of morbidity associated with open reduction and internal fixation of the fractured condyle by the transparotid approach. Br J Oral Maxillofac Surg 47(5):370–373
Ellis E 3rd, McFadden D, Simon P, Throckmorton G (2000) Surgical complications with open treatment of mandibular condylar process fractures. J Oral Maxillofac Surg 58(9):950–958
Undt G, Kermer C, Rasse M, Sinko K, Ewers R (1999) Transoral miniplate osteosynthesis of condylar neck fractures. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 88(5):534–543
Vesnaver A, Gorjanc M, Eberlinc A, Dovsak DA, Kansky AA (2005) The periauricular transparotid approach for open reduction and internal fixation of condylar fractures. J Cranio Maxillofac Surg 33(3):169–179
Vogt A, Roser M, Weingart D (2005) Transparotidean approach to surgical management of condylar neck fractures. A prospective study. Mund Kiefer Gesichtschir 9(4):246–250
Devlin MF, Hislop WS, Carton AT (2002) Open reduction and internal fixation of fractured mandibular condyles by a retromandibular approach: surgical morbidity and informed consent. Br J Oral Maxillofac Surg 40(1):23–25
Manisali M, Amin M, Aghabeigi B, Newman L (2003) Retromandibular approach to the mandibular condyle: a clinical, cadaveric study. Int J Oral Maxillofac Surg 32(3):253–256
Palmieri C, Ellis E 3rd, Throckmorton G (1999) Mandibular motion after closed and open treatment of unilateral mandibular condylar process fractures. J Oral Maxillofac Surg 57(7):764–775
Iannetti G, Cascone P (1995) Use of rigid external fixation in fractures of the mandibular condyle. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 80(4):394–397
Widmark G, Bagenholm T, Kahnberg KE, Lindahl L (1996) Open reduction of subcondylar fractures: a study of functional rehabilitation. Int J Oral Maxillofac Surg 25(2):107–111
De Riu G, Gamba U, Anghinoni M, Sesanna E (2001) A comparison of open and closed treatment of condylar fractures: a change in philosophy. Int J Oral Maxillofac Surg 30(5):384–389
Sugiura T, Yamamoto K, Murakami K, Sugimura M (2001) A comparative evaluation of osteosynthesis with lag screws, miniplates, or Kirschner wires for mandibular condylar process fractures. J Oral Maxillofac Surg 59(10):1161–1168
Villarreal PM, Monje F, Junquera LM, Mateo J, Morillo AJ, Gonzalez C (2004) Mandibular condyle fractures: determinants of treatment and outcome. J Oral Maxillofac Surg 62(2):155–163
Choi BH, Yi CK, Yoo JH (2001) Clinical evaluation of 3 types of plate osteosynthesis for fixation of condylar neck fractures. J Oral Maxillofac Surg 59(7):734–737
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Bindra, S., Choudhary, K., Sharma, P. et al. Management of Mandibular Sub Condylar and Condylar Fractures Using Retromandibular Approach and Assessment of Associated Surgical Complications. J. Maxillofac. Oral Surg. 9, 355–362 (2010). https://doi.org/10.1007/s12663-010-0133-5
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DOI: https://doi.org/10.1007/s12663-010-0133-5