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Comparison of Approaches for the Rigid Fixation of Sub-Condylar Fractures

  • Clinical Study
  • Published:
Journal of Maxillofacial and Oral Surgery Aims and scope Submit manuscript

Abstract

Aim

The objective of this study was to compare the rate of complications encountered on using different incisions to access the fracture site for the open reduction and internal fixation of isolated subcondylar fractures. The parameters evaluated are: the occurrence of salivary fistula, infection, and injuries to the seventh facial nerve. An assessment of the surgical scar was also undertaken.

Materials and Methods

20 patients who met the previous criteria and were willing to participate in the study were placed (five each) into the pre-auricular, submandibular, retromandibular transparotid or retromandibular transmassetric group based on the incision scar they selected after a description of the operation and being explained about the possible complications.

Results and Conclusion

Comparison of the complications could not ascertain the superiority of any approach over the other since the outcomes were not statistically significant. However, judging by operator and assistants’ subjective assessment, the retromandibular approaches seem to provide a more direct visual field and an almost straight line access for the fixation of the fracture. The transmassetric approach seems to be a safer approach since the nerves encountered can be visualized and avoided.

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References

  1. Ellis E 3rd, Palmieri C, Throckmorton G (1999) Further displacement of condylar process fractures with closed treatment. J Oral Maxillofac Surg 57(11):1307–1316

    Article  PubMed  Google Scholar 

  2. Ellis E 3rd, Throckmorton GS, 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

    Article  PubMed  Google Scholar 

  3. Ellis E 3rd, Throckmorton GS (2000) Facial symmetry after closed and open treatment of fractures of the mandibular condylar process. J Oral Maxillofac Surg 58(7):719–728

    Article  PubMed  Google Scholar 

  4. Ellis E 3rd, Throckmorton G (2001) Bite forces after open or closed treatment of mandibular condylar process fractures. J Oral Maxillofac Surg 59(4):389–395

    Article  PubMed  Google Scholar 

  5. Ellis E 3rd, McFadden D, Simon P, Throckmorton G (2000) Surgical complications with open treatment of mandibular condylar process fractures. J Oral Maxillofac Surg 59:950–958

    Article  Google Scholar 

  6. Lutz JC, Clavert P, Wolfram-Gabel R, Wilk A, Kahn JL (2010) Is the high submandibular transmasseteric approach to the mandibular condyle safe for the inferior buccal branch? Surg Radiol Anat 32(10):963–969

    Article  PubMed  Google Scholar 

  7. Hammer B, Schier P, Prein J (1997) Osteosynthesis of condylar neck fractures: a review of 30 patients. Br J Oral Maxillofac Surg 35(4):288–291

    Article  PubMed  CAS  Google Scholar 

  8. Widmark G, Bågenholm 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

    Article  PubMed  CAS  Google Scholar 

  9. Tang W, Gao C, Long J, Lin Y, Wang H, Liu L, Tian W (2009) Application of modified retromandibular approach indirectly from the anterior edge of the parotid gland in the surgical treatment of condylar fracture. J Oral Maxillofac Surg 67(3):552–558

    Article  PubMed  Google Scholar 

  10. Trost O, Trouilloud P, Malka G (2009) Open reduction and internal fixation of low subcondylar fractures of mandible through high cervical transmasseteric anteroparotid approach. J Oral Maxillofac Surg 67(11):2446–2451

    Article  PubMed  Google Scholar 

  11. Wiwanitkit V (2010) High cervical transmasseteric anteroparotid approach for low subcondylar fracture of mandible. J Oral Maxillofac Surg 68(4):951 author reply 951–952

    Article  PubMed  Google Scholar 

  12. Trost O, El-Naaj IA, Trouilloud P, Danino A, Malka G (2008) High cervical transmasseteric anteroparotid approach for open reduction and internal fixation of condylar fracture. J Oral Maxillofac Surg 66(1):201–204

    Article  PubMed  Google Scholar 

  13. 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 Endod 82(3):248–252

    Article  PubMed  CAS  Google Scholar 

  14. Meyer C, Zink S, Chatelain B, Wilk A (2008) Clinical experience with osteosynthesis of subcondylar fractures of the mandible using TCP plates. J Craniomaxillofac Surg 36(5):260–268

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Professor and Head of the Department, Sree Balaji Dental College and Hospital, Pallikaranai, Chennai, India

    Vijay Ebenezer

  2. Sree Balaji Dental College and Hospital, Pallikaranai, Chennai, India

    Balakrishnan Ramalingam

Authors
  1. Vijay Ebenezer
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  2. Balakrishnan Ramalingam
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Correspondence to Vijay Ebenezer.

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Ebenezer, V., Ramalingam, B. Comparison of Approaches for the Rigid Fixation of Sub-Condylar Fractures. J. Maxillofac. Oral Surg. 10, 38–44 (2011). https://doi.org/10.1007/s12663-010-0145-1

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  • DOI: https://doi.org/10.1007/s12663-010-0145-1

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