Fractures of the Mandibular Condyle

Vincent, Aurora G.; Ducic, Yadranko; Kellman, Robert M.

doi:10.1055/s-0039-1700888

Cited by 27 publications

(39 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Lately however, there has been a paradigm shift towards the consideration of open approaches to condylar fractures as the gold standard of treatment 13 , owing in part to the advent of functionally stable osteosynthesis in the 1980s and to the multitude of benefits associated with early mobilization and loading of the temporomandibular joint. While open reduction and internal fixation of condylar fractures is gaining traction in the OMFS world, there is yet to be a standardized protocol of approaches to the condyle 14 . This study was undertaken in order to examine two different approaches to the condylar neck and base, the transparotid and retroparotid modifications of the retromandibular approach, in order to establish which of the two had a more favorable outcome in terms of function, aesthetics and lower post-surgical complications.…”

Section: Discussionmentioning

confidence: 99%

The retromandibular transparotid approach vs. retromandibular retroparotid approach for the mandibular condyle

et al. 2021

View full text Add to dashboard Cite

Aim: The mandible is regarded as a frequently fractured bone in patients who present with maxillofacial trauma accounting for almost 15.5% to 59% of all facial fractures. Managing condylar trauma has remained to be a point of contention amongst experts, regardless of the advances in surgical modalities and methodologies, and the treatment plan is often determined by the preference and the experience of the surgeon. There exist various approaches in the literature, each with its own specific benefits and drawbacks. With this study, we aimed to evaluate the prevalence of post-operative complications in patients who experienced ORIF by means of the retromandibular approach, by comparing the outcomes of one group having undergone transparotid surgery, with another that underwent retroparotid surgery. Methods: An experimental trial was undertaken. Convenience sampling was done from among the cases of condylar neck and base fracture visiting the department of OMFS, Dow University of Health Sciences from January 2017 to December 2019. An overall 26 patients were divided into 2 groups of 13 members each; one was managed using Open Reduction Internal Fixation (ORIF) by means of a retromandibular transparotid approach while the other group was treated with ORIF by means of a retromandibular retroparotid approach. A 6 month follow-up was done to assess range of active motion, occlusion, and complications such as deviation/deflection, neural injury, infections, sialocele, salivary fistulae and Frey’s syndrome in both groups. Results: There was no statistically significant difference between the two groups in terms of inter-incisal opening, right and left lateral movements, or protrusion. One patient in the retroparotid group had deviation on mouth opening (7.69%), while one in the transparotid group reported with infection (7.69%), and 2 developed post operative seromas (15.38%). None had persisting facial nerve palsy at 6 months. Conclusion: We find no significant disparity between the 2 approaches at a follow-up of 6 months; therefore, the primary determining factor for selection of either technique is surgeon preference and appropriate case selection.

show abstract

Section: Discussionmentioning

confidence: 99%

The retromandibular transparotid approach vs. retromandibular retroparotid approach for the mandibular condyle

et al. 2021

View full text Add to dashboard Cite

show abstract

“…While the management of condylar fractures has been extensively studied and reported [9,21,22,[24][25][26]28,31], there remains no consensus on what the best treatment method should include [32]. Continued debate on the optimal management methods may stem from the heterogeneity of published studies [33].…”

Section: Discussionmentioning

confidence: 99%

Open Rigid Internal Fixation of Low-Neck Condylar Fractures of the Mandible: Mechanical Comparison of 16 Plate Designs

et al. 2020

View full text Add to dashboard Cite

Background: In the literature, no information on plates for low-neck mandibular condylar osteosynthesis can be found, despite the fact that 30 plate designs have already been published. The aim of this study was to compare any dedicated plates for possible use in low-neck condylar fracture osteosynthesis. Methods: The force required for 1-mm displacement of the fixed fracture fragments and incidents of screw loosening were recorded on polyurethane mandibles among 16 designs of titanium plates fixed by 6-mm screws in a 2.0 system. Results: Double-straight plate fixation was the mechanical gold standard (15.2 ± 3.5 N), followed by A-shape Condylar Plates (14.9 ± 2.1 N), X-shape Condylar Plates (14.2 ± 1.3 N) and Auto Repositioning Plates (11.8 ± 2.4 N). Screw loosening was uncommon, as a minimum of three screws were placed into the condylar part. Fewer screws were lost from the ramus part of the fixation if the plate was attached to the condylar part by three screws. Often, the stability of the ramus screws was lost when there were only two fixing screws in the condyle (p < 0.001). Conclusions: It is advisable to consider the mechanical advantages as one decides which plate to choose for open rigid internal fixation in low-neck condylar fractures, or to only be aware of the significant differences in mobility within the fracture line after fixation with different dedicated plates.

show abstract

“…Condylar fractures must be managed according to the clinical and case presentation. 9 In this specific case, because there was no sliding of the condyle into the middle cranial fossa, no extracapsular displacement of the condyle, no presence of a foreign body inside the articular capsule, nor mechanical obstruction preventing the function of the temporomandibular joint, 10 we opted for conservative treatment. Surgical reduction of the mandibular symphysis fracture under general anaesthesia and nasotracheal intubation was proposed.…”

Section: Case Reportmentioning

confidence: 99%

Surgical Reduction of Symphysis Fracture and Spontaneous Repositioning of the Mandibular Condyle: A Case Report

Carvalho¹

2021

SOJDOD

View full text Add to dashboard Cite

The condylar process is a more fragile area, which is usually fractured by indirect trauma. The objective of this study is to report the case of a 10-year-old patient who presented to the Maxillofacial Surgery and Traumatology Service of the Regional Hospital of Vale do Paraíba, in Taubaté-SP, Brazil. Physical examination revealed limited mandibular movement with painful symptoms, crossbite, and upper incisor avulsion. A face tomography showed a fracture of the mandibular symphysis (right side) and a fracture of the left condyle. Surgical reduction of the mandibular symphysis fracture was performed. After exposure and reduction of bone segments, maxillomandibular block, rigid internal fixation and conservative treatment for condyle fracture were performed. A soft liquid diet and weekly outpatient follow-up was adopted for the first two months. After 15 days of surgery, the patient had mild edema, slight limitation in mouth opening, sutures without dehiscence and without signs of infection. In the first control tomography, the treated fracture was adequately reduced and the fractured condyle remained with medial displacement in the glenoid cavity. After one year, on physical examination, the patient presented satisfactory dental occlusion, preserved mandibular movements and no signs of nerve damage. The tomography showed the fracture consolidated, and the left mandibular condyle well positioned in the glenoid cavity. After two years, the third tomography was performed, showing remodelling of the left mandibular condyle.

show abstract

Fractures of the Mandibular Condyle

Cited by 27 publications

References 30 publications

The retromandibular transparotid approach vs. retromandibular retroparotid approach for the mandibular condyle

The retromandibular transparotid approach vs. retromandibular retroparotid approach for the mandibular condyle

Open Rigid Internal Fixation of Low-Neck Condylar Fractures of the Mandible: Mechanical Comparison of 16 Plate Designs

Surgical Reduction of Symphysis Fracture and Spontaneous Repositioning of the Mandibular Condyle: A Case Report

Contact Info

Product

Resources

About