Bilateral mandibular condyle fractures: Should we open both?

Seshappa, Kedarnath Nakkalahalli; Rangaswamy, Shruthi

doi:10.4103/njms.njms_10_19

Cited by 4 publications

(3 citation statements)

References 9 publications

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“…Although many studies have suggested ORIF for BCF in adult patients, this was not the case for children, as cases reported in the literature suggest that conservative treatment should be the first‐line choice for pediatric patients 22 . The result of the present case is consistent with those reported in the literature, in which the conservative approach was chosen for many reasons, including patient age and medical condition as mentioned above.…”

Section: Discussionmentioning

confidence: 99%

Conservative management and follow‐up of bilateral condylar fractures in pediatric patients: A case report

Nourwali,

Aljohani

2023

Clinical Case Reports

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Key Clinical MessageConservative treatment of bilateral condylar fractures, including intermaxillary fixation using arch bars and elastic bands, yields satisfactory results in pediatric patients. Therefore, the conservative approach should be considered the first line of treatment for bilateral condylar mandibular fractures in pediatric patients.AbstractRoad traffic accidents (RTAs) are considered the leading cause of mortality and morbidity of children and adults in Saudi Arabia. Head injuries and fractures are the most common form of injuries resulting from RTAs, with mandibular fractures being the most common head injury; condylar fractures are the most frequent type of mandibular fracture. A review of the literature reveals diverse opinions about the best approach for treating bilateral condylar fractures in pediatric patients. The findings of the literature review are reported in this study. The case presented here shows the result of adopting a conservative approach to treating a bilateral extracapsular displaced condylar fracture. An elastic band was fixed onto intermaxillary fixation (IMF) screws at the midline upper and lower jaws; the patient was followed up for almost 3 years. The conservative approach yielded excellent results, as both condyles were fully repositioned and healed, without causing any deviation or limitation of the mouth opening. The results of this case support considering the conservative approach as the first line of treatment for bilateral condylar mandibular fractures in pediatric patients.

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Section: Discussionmentioning

confidence: 99%

Conservative management and follow‐up of bilateral condylar fractures in pediatric patients: A case report

Nourwali,

Aljohani

2023

Clinical Case Reports

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“…The incidence of these complications is considered to be great. The majority of the cases of ankylosis were caused by unreplaced nonsurgically treated condyles [12].…”

Section: Discussionmentioning

confidence: 99%

Comparison between Two Different Fixation Techniques on Experimentally Induced Unilateral Subcondylar Fracture in TMJ of the Dogs (Histopathological and Histomorphometrical Study)

Ibrahim¹,

Omar²,

Alqalshy³

et al. 2022

Preprint

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Objectives: The present study was performed to compare between two different fixation techniques and evaluate the histopathological changes which occur in temporomandibular joint (TMJ) of the dogs after surgically induced unilateral subcondylar fracture. Methods: Twenty- One healthy beagle male dogs with a mean age of 30 months were used in the present study. One of these animals was sacrificed to study the normal histology of the dog TMJ. The rest of the animals (20 animals) were operated on to induce a displaced unilateral subcondylar fracture then, the animals were randomly equally divided into 2 groups. After surgery, 5 dogs of each group were sacrificed at 2 months after surgery (Short-Term), while the remaining 5 were sacrificed at 4 months after surgery (Long-Term). The heads were separated and fixed, oscillating saw was used to articulate the entire TMJ. Specimens were decalcified, then the specimens were washed, grossed and sectioned in a sagittal plane. Tissue sections of 4 um thick were cut and stained with Hematoxylin and Eosin to be studied microscopically. Results: In group I animals, at 2 months after surgery, there was a marked hypertrophy of the articular fibrous covering of the condylar head, while at 4 months after surgery, the articular fibrous covering appeared thinner than normal, with marked decrease in thickness of the articular cartilage layer. In group II, at 2 months after plate insertion, the articular fibrous covering became hypertrophic, and the articular cartilage was markedly reduced but it was of a uniform thickness, while at 4 months after subcondylar fracture and plate fixation, no significant changes could be detected either in thickness or structure of the articular fibrous covering. Conclusion: Based on this study, it is obvious that the plate fixation group gave the most favorable results, when compared with maxillomandibular fixation (MMF) group.

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“…Condylar fractures may be isolated unilateral or bilateral fractures or could present concomitantly with other maxillofacial injuries [1]. Approximately 40% to 50 % of condylar fractures are bilateral [2]. Despite this high prevalence, the management is controversial at best due to different schools of thought and a lack of consensus among surgeons worldwide.…”

Section: Introductionmentioning

confidence: 99%

Let Bilateral Condylar Fracture Fixation Be the Norm and Not a Choice

Punga¹,

Gaur²

2022

Cureus

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In lieu of a lack of consensus among the global community, it becomes imperative to address the pitfalls in the surgical management of bilateral mandibular condylar fractures with the contemporary technique of open reduction and internal fixation of only one side. This dictum inevitably leads to postoperative complications despite the best efforts of the surgical team to optimize care. We present a case series comprising residual deformities and complications arising out of the inadequate treatment of bilateral condylar fractures. We aim to highlight the significance of open reduction and internal fixation of bilateral mandibular condylar fractures and reiterate that conventional subcondylar osteotomy is an effective method for revision surgery.

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Bilateral mandibular condyle fractures: Should we open both?

Cited by 4 publications

References 9 publications

Conservative management and follow‐up of bilateral condylar fractures in pediatric patients: A case report

Conservative management and follow‐up of bilateral condylar fractures in pediatric patients: A case report

Comparison between Two Different Fixation Techniques on Experimentally Induced Unilateral Subcondylar Fracture in TMJ of the Dogs (Histopathological and Histomorphometrical Study)

Let Bilateral Condylar Fracture Fixation Be the Norm and Not a Choice

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