Extracorporeal Plating of High-Level Condyle fracture Through Retromandibular Approach - A Technical Note

Abstract

The complex anatomy of the mandibular condyle makes its fracture management challenging and debatable. Apart from this, the approaches to condyle are also challenging as most of them depend on the surgical expertise. The retromandibular approach which was initially proposed for the vertical sub condylar osteotomies was later popularized for condyle fracture management. It is considered to be a gold standard approach in the management of low condylar fractures. Although it has its own demerits in managing high condylar fracture due to its poor access and visibility, the major complications of temporary facial nerve paresis and sialocele are very less compared to other approaches. However, modified extracorporeal plating combined with retromandibular approach proves to be effective in managing high condylar fracture. In this article, we discuss about a case of bilateral neck of condyle fracture that has been managed with the combined modified extracorporeal plating with retromandibular approach and has been followed with no complications for about 1 year.

Keywords: Condyle fractures; extracorporeal plating; retromandibular approach; temporary facial nerve paresis.

Figure 1

Mouth opening of the patient

Figure 2

Orthopantomogram reveals bilateral condyle fracture

Figure 3

Hinds incision placed on right side and fracture site exposed

Figure 4

Fracture reduction and fixation done

Figure 5

Condyle plating done extraorally

Figure 6

Plated condyle repositioned into the fossa

Figure 7

Postoperative orthopantomogram at 1-year follow-up