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. 2024 Sep;17(3):225-231.
doi: 10.1177/19433875231194242. Epub 2023 Aug 4.

Comparing Current Practice Habits for Treatment of Subcondylar Fracture Among Craniomaxillofacial Surgeons

Heather K Schopper  1 , Brandyn Dunn  2 , Richard Davila  3 , Kevin J Sykes  1 , John P Flynn  1 , J David Kriet  1 , Clinton D Humphrey  1
Affiliations

Comparing Current Practice Habits for Treatment of Subcondylar Fracture Among Craniomaxillofacial Surgeons

Heather K Schopper et al. Craniomaxillofac Trauma Reconstr. 2024 Sep.

Abstract

Study design: Survey.

Objective: Subcondylar fractures stand out as a particular challenge when treating maxillofacial trauma. The fracture site is often difficult to access and adjacent to critical structures like the facial nerve. Current treatment paradigms vary widely and we endeavored to elucidate these approaches from surgeons across the full breadth of Craniomaxillofacial Surgery.

Methods: A survey was designed to gather general background training and experience information, perceived indications for ORIF of subcondylar fractures, options for treating subcondylar fractures, and reasoning for choosing or not choosing a given treatment approach. The survey was sent to members of AO CMF and the American Academy of Facial Plastic Surgery. Responses were collected for 4 weeks.

Results: 514 total responses to the survey were obtained (response rate 17%). Of these, 43 (8.4%) identified as Otolaryngology trained, 417 (81.1%) as OMFS trained, and 54 (10.5%) as Plastic Surgery trained. While there was broad agreement in the indications for open repair, surgical approaches differed by specialty background as well as AO faculty member status. Those with less experience were less likely to perform open approaches due to lack of comfort with this skill set.

Conclusions: There are some key differences in approaches to treatment of subcondylar fractures based upon specialty background and experience level. This provides an opportunity for further education to ensure optimal treatment for patients.

Keywords: maxillomandibular fixation; open reduction; oral maxillofacial surgery; otolaryngology; plastic surgery; subcondylar fracture.

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Conflict of interest statement

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: C. Humphrey is a consultant for Invisian Medical LLC. All other authors deny any potential conflicts of interest.

Figures

Figure 1.
Figure 1.
Indications for open treatment by specialty (%).
Figure 2.
Figure 2.
Treatment approaches to subcondylar fractures with indications for open repair by treatment discipline.
Figure 3.
Figure 3.
Treatment approaches to subcondylar fractures with indications for open repair by surgical volume.
Figure 4.
Figure 4.
Treatment approaches to subcondylar fractures with indications for open repair by time in practice.
Figure 5.
Figure 5.
Reasoning for avoidance of open approaches by time in practice.
See this image and copyright information in PMC

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