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. 2024 May 22;54(5):1082-1091.
doi: 10.55730/1300-0144.5887. eCollection 2024.

Open surgical approach to fractures of the mandibular condyle: surgical technique and associated complications

Cenk Demirdöver  1 , Alper Geyik  1
Affiliations

Open surgical approach to fractures of the mandibular condyle: surgical technique and associated complications

Cenk Demirdöver et al. Turk J Med Sci. .

Abstract

Background/aim: This study evaluates anatomical reduction and rigid internal fixation of mandibular condyle fractures using the preauricular retroparotid approach. It also discusses advantages, deficiencies, and associated complications of the technique.

Materials and methods: This retrospective study reviewed the medical records of a total of 52 mandibular condyle fractures from 42 patients who were treated with open surgery using the preauricular retroparotid approach between January 2019 and January 2024. Preoperative and postoperative assessments included measurements of mouth opening (maximum interincisal distance), vertical mandibular movement, and facial paralysis. Moreover, the Vancouver Scar Scale (VSS) was used to evaluate scar quality at the surgical site. Descriptive statistics were used to summarize patient demographics, preoperative findings, and postoperative outcomes.

Results: Anterior open bite was the most common finding, detected in 83% of the patients before surgery. The mean mouth opening of the patients increased significantly from 29 ± 4.94 mm to 37.76 ± 2.12 mm. Vertical mandibular movement exceeding 4 cm was a finding in more than half (52.3%) of the patients. The mean VSS score, indicating scar quality, was 1.64 ± 0.70, suggesting overall good cosmetic outcomes. Plate breakage in two patients was noted as a complication during follow-up.

Conclusion: Several surgical techniques have been described for mandibular condyle fractures, each with its own benefits and limitations.

Keywords: Maxillofacial surgery; complications; internal fracture fixation; mandibular condyle; mandibular fractures.

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Figures

Figure 1
Figure 1
Exposure of anatomic structures before dissecting the condyle and the fracture site.
Figure 2
Figure 2
Fixation of the condylar neck fracture with an L-shaped miniplate.
Figure 3
Figure 3
Fixation of the subcondylar fracture with a bent miniplate.
Figure 4
Figure 4
Extracorporeal fixation of the condyle fracture.
Figure 5
Figure 5
Postoperative CT scan of a condyle fracture after fixation.
Figure 6
Figure 6
Postoperative view of plate failure in a condyle fracture.
Figure 7
Figure 7
Three-dimensional image of a patient after fixation for condyle fracture.
See this image and copyright information in PMC

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