Is the retromandibular approach a suitable approach to anatomical reduction of unilateral subcondylar fracture? A non-randomized clinical trial

Abstract

The aim of this study was to evaluate the efficacy of the retromandibular approach (RMA) to produce three-dimensional (3-D) reduction of the unilateral subcondylar fracture and Temporomandibular Joint (TMJ) functional implication.Methods: A prospective cohort study was designed. Twenty-nine patients with unilateral subcondylar fracture underwent consecutively Open Reduction, and Internal Fixation. The cohorts were divided into two groups; RMA group (n = 16, 55.17%) and submandibular approach SMA group (n = 13, 44.82%). The primary outcome was the anatomical 3-D reduction of the condyle. The secondary outcome was to compare the condyle position and inclination finding with TMJ outcomes. Helkimo Index score was used to evaluate the TMJ outcome at six months postoperatively.Result: There was a significant difference between the mediolateral condylar inclination, condylar medial and vertical positions when RMA compared with SMA groups (P < 0.05). The medial joint space was correlated with the medial condylar position in both groups (P < 0.05). The Helkimo Ai and Di was associated with mediolateral condylar inclination in SMG; however, Helkimo Ai was found to be correlated with the RMA group.Conclusion: The current study demonstrates that the RMA could re-establish the anatomical position of the unilateral subcondylar fracture in patients undergoing ORIF. The clinical outcome of the TMJ with RMA was better than SMA.

Study of Facial Nerve Function Following Retromandibular Open Reduction of Mandibular Condylar Fracture

“…1 They can further lead to morphological & functional damage when undetected or poorly managed. 2 Condylar fractures that are misdiagnosed or improperly treated can cause substantial functional impairment, such as malocclusion, decreased mouth opening due to jaw deviation, and restricted lateral mandibular motions. 1 A commonly acknowledged form of therapy for mandibular condylar fractures is internal fixation & open reduction of the broken mandibular condyle, which routinely results in positive efficient results.…”

A Temporary Intraoperative Fixation Method for the Absorbable Plates Fixation of Condylar Fracture by Retromandibular Transparotid Approach

“…Compared with a conventional titanium plate system, an absorbable plate obviates the need for plate removal; however, the absorbable plate system involves complicated procedures, 5 which need adequate exposure of the operative field and less interfere by the surrounding soft tissues. The retromandibular transparotid approach is commonly used for open treatment of subcondylar fractures, which provides the shortest and the most direct access to the subcondylar area 6,7 . However, this approach carries the risk of damaging parotid tissue, blood vessels, and facial nerve due to the limited operative field exposure.…”