scholarly journals Management of Zygomatic Arch Fractures by Intraoral Open Reduction and Transbuccal Fixation: A Technical Note

2020 ◽  
Vol 13 (2) ◽  
pp. 130-132
Author(s):  
Elavenil Panneerselvam ◽  
Sasikala Balasubramanian ◽  
Jaghandeep Kempraj ◽  
Vijitha Ravindira Babu ◽  
V. B. Krishna Kumar Raja
Keyword(s):  
Facial Nerve ◽  
Internal Fixation ◽  
Open Reduction ◽  
Simple Technique ◽  
Technical Note ◽  
Zygomatic Arch ◽  
Arch Form ◽  
Clinical Presentations ◽  
The Face ◽  
Post Traumatic

Fractures of the zygomatic arch are common due to its anatomical prominence. The post-traumatic restoration of the arch form is important to maintain the midfacial symmetry and anteroposterior projection of the face. Open reduction and internal fixation (ORIF) of fractured arch is indicated in specific clinical presentations. The traditional methods of ORIF of zygomatic arch fractures require cutaneous incisions, which are associated with complications such as scarring and facial nerve injury. This article presents a simple technique of “intraoral reduction and transbuccal fixation” of the arch that negates the problems associated with the conventional approaches to ORIF.

Complications of the Transmasseteric Anteroparotid Approach for Subcondylar Fractures: A Retrospective Study

2021 ◽  
pp. 194338752110169
Author(s):  
Jared Gilliland ◽  
Fabio Ritto ◽  
Paul Tiwana
Keyword(s):  
Retrospective Study ◽  
Facial Nerve ◽  
Internal Fixation ◽  
Closed Reduction ◽  
Open Reduction ◽  
Mouth Opening ◽  
Facial Nerve Paralysis ◽  
Nerve Paralysis ◽  
University Of Oklahoma ◽  
The University

Study Design: A retrospective analysis of patients with subcondylar fractures treated via a transmasseteric anteroparotid approach by the Oral and Maxillofacial Department at the University of Oklahoma. Objective: The goal of this study was to evaluate complications, morbidity, and safety with the transmasseteric anteroparotid approach for treatment of subcondylar fractures, and compare it to other findings previously reported in the literature. Methods: A retrospective study was conducted that consisted of 23 surgically treated patients in the past 2 years for subcondylar fractures. Only patients with pre-operative malocclusion and who underwent open reduction with internal fixation with the transmasseteric anteroparotid (TMAP) approach were included. Exclusion criteria included 1) patients treated with closed reduction 2) patients who failed the minimum of 1, 3, and 6-week post-operative visits. The examined parameters were the degree of mouth opening, occlusal relationship, facial nerve function, incidence of salivary fistula and results of imaging studies. Results: 20 of the surgically treated patients met the inclusion criteria. Two patients were excluded due to poor post-operative follow up and 1 was a revision of an attempted closed reduction by an outside surgeon that presented with pre-existing complications. There were no cases of temporary or permanent facial nerve paralysis reported. There were 3 salivary fistulas and 2 sialoceles, which were managed conservatively and resolved within 2 weeks, and 2 cases of inadequate post-surgical maximal incisal opening (<40 mm) were observed. Conclusion: The transmasseteric anteroparotid approach is a safe approach for open reduction and internal fixation of low condylar neck and subcondylar fractures, and it has minimal complications.

scholarly journals Nasal/maxillofacial manifestations of head and neck injury

2017 ◽  
Vol 3 (3) ◽  
pp. 555
Author(s):  
Siddaram Patil ◽  
Girish P. B.
Keyword(s):  
Head Injury ◽  
Internal Fixation ◽  
General Anesthesia ◽  
Open Reduction ◽  
Mandibular Fractures ◽  
Medical College ◽  
Traumatic Amnesia ◽  
Post Traumatic ◽  
Waking Up ◽  
Head And Neck Injury

<p class="abstract"><strong>Background:</strong> A great deal of work has been directed toward using these symptoms to classify the severity of head injury. Loss of consciousness or coma and posttraumatic amnesia (difficulty in remembering new information after waking up from the coma) are the two most common symptoms used. A mild head injury is one in which the period of unconsciousness is less than twenty minutes and post traumatic amnesia lasts for less than one hour, while a head injury in which the person is unconscious for at least one day and experiences post traumatic amnesia for more than twenty four hours is considered severe<span lang="EN-IN">. </span></p><p class="abstract"><strong>Methods:</strong> 50 Cases coming to O.P.D and casualty of Chigateri general hospital and Bapuji hospital attached to JJM Medical College, Davangere were studied<span lang="EN-IN">.  </span></p><p class="abstract"><strong>Results:</strong> Evidence of C.S.F rhinorrhoea was noticed in 1(2%) case which managed conservatively. Maxillary fracture was noticed in 05 (10%) cases which were managed conservatively. Zygomatic fractures were noticed in 07 (14%) cases which were managed by open reduction and internal fixation with mini plates under general anesthesia<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> Mandibular fractures were noticed in 10 (20%) of cases which were managed by open reduction and internal fixation with mini plates under general anesthesia<span lang="EN-IN">.</span></p>

scholarly journals CRB modification to retromandibular approach for management of subcondylar fractures.

2019 ◽  
Vol 6 (3) ◽  
pp. 84-87
Author(s):  
Chandrashekhar Bande ◽  
Krishna Kurawar ◽  
Ashish Maheshkar ◽  
Ankita Bhagat ◽  
Manu Goel
Keyword(s):  
Postoperative Complications ◽  
Facial Nerve ◽  
Internal Fixation ◽  
Open Reduction ◽  
Good Alternative ◽  
Surgical Access ◽  
Subcondylar Fracture ◽  
Ease Of Access ◽  
Scar Mark

The aim of this study was to evaluate the efficacy of CRB modification of retromandibular approach to gain surgical access for open reduction and internal fixation of mandibular subcondylar fractures. A total number of 264 sustained extra-capsular subcondylar fractures from 230 patients were selected for the study over the period of 5 years. Evaluation of intraoperative accessibility, postoperative facial nerve function, postoperative complications and scar was carried out. All the patients were treated using CRB Curvilinear approach. Patient follow up was recorded for 1 year on a regular interval basis. Symptoms of postoperative facial nerve injury were seen in 2 patients which recovered with time, postoperative complications were not encountered in any case and minimum scar mark hidden in the cervical skin crease. Hence open reduction and internal fixation for Subcondylar fracture of mandible by using the CRB modification of retromandibular approach is a good alternative for other conventional approaches in having ease of access, ease of fixation, reduced incidences of injury to facial nerve and its branches with good aesthetic outcome.

scholarly journals Traumatic atlantoaxial rotatory subluxation in adults – A case report and literature review

2020 ◽  
Vol 11 ◽  
pp. 376
Author(s):  
Hugo Layard Horsfall ◽  
Aref-Ali Gharooni ◽  
Alaa Al-Mousa ◽  
Anan Shtaya ◽  
Erlick Pereira
Keyword(s):  
Neck Pain ◽  
Internal Fixation ◽  
Open Reduction ◽  
Motor Vehicle ◽  
English Literature ◽  
Open Reduction Internal Fixation ◽  
Vehicle Accidents ◽  
Pediatric Populations ◽  
Rotatory Subluxation ◽  
Post Traumatic

Background: Traumatic atlantoaxial rotatory subluxation (AARS) is extremely rare in adult versus pediatric populations. Patients usually present with post-traumatic neck pain and torticollis. Surgical management aims at reducing the deformity and stabilizing the spine utilizing external orthotics, and/or internal reduction/fixation. Methods: A 65-year-old female fell downstairs at home. She complained of neck pain with right-sided tenderness and torticollis. The radiographic studies and CT scan demonstrated AARS. This led to an emergent open reduction with internal fixation at the C1-C2 level. Results: We identified 25 similar cases of AARS in the English literature. Patients averaged 28.7 years of age and mostly sustained motor vehicle accidents largely treated with traction/orthotics; only six patients required surgical open reduction/internal fixation. Conclusion: In this case, the patient’s C1-C2 deformity required open reduction/internal fixation rather than bracing alone.

The Use of Dual C-Arms During Fixation of Calcaneal Fractures

2013 ◽  
Vol 7 (3) ◽  
pp. 207-209 ◽  
Author(s):  
Mostafa M. Abousayed ◽  
Rull James Toussaint ◽  
John Y. Kwon
Keyword(s):  
Internal Fixation ◽  
Expert Opinion ◽  
Open Reduction ◽  
Operative Time ◽  
Simple Technique ◽  
Intraoperative Imaging ◽  
Arm Movement ◽  
Open Reduction Internal Fixation ◽  
Calcaneal Fractures ◽  
Lateral Decubitus

We describe a simple technique using dual C-arms (large and mini C-arm together) for open reduction internal fixation of calcaneal fractures in the lateral decubitus position that (1) decreases the difficulty of obtaining proper intraoperative imaging; (2) limits C-arm movement, which decreases risk of contamination and operative time; and (3) minimizes the drawbacks of each imaging fluoroscopic modality. Levels of Evidence: Level V, Technical tip, Expert opinion

scholarly journals Clinical Assessment of Retromandibular Antero-Parotid Approach for Reduction of Mandibular Subcondylar Fractures: Report of 60 Cases and Review of the Literature

2020 ◽  
Author(s):  
Alireza Parhiz ◽  
Milad Parvin ◽  
Sasan Sanjari Pirayvatlou
Keyword(s):  
Salivary Gland ◽  
Facial Nerve ◽  
Internal Fixation ◽  
Clinical Assessment ◽  
Open Reduction ◽  
Direct Access ◽  
Review Of The Literature ◽  
Surgical Scar ◽  
Low Level ◽  
The Mean

This study assessed the efficacy of the retromandibular antero-parotid approach for open reduction and internal fixation (ORIF) of subcondylar fractures. Sixty patients with the mean age of 31.03 years underwent surgical reduction with a 20-25mm incision in the retromandibular area with an antero-parotid transmasseteric approach. All patients were followed between 6 to 12 months. At the end of the first week, six patients exhibited postoperative malocclusion. At the next visits, all patients had optimal occlusion. Maximal interincisal opening (MIO) of 56 patients (93.3%) was >37mm, and only four patients (6.7%) had MIO<37mm. In three patients (5%), weakness of the buccal branch of the facial nerve was noticed postoperatively. No salivary gland complications were seen. The surgical scar was hardly noticeable. Retromandibular access with transmasseteric antero-parotid approach is the technique of choice for treatment of high- and low-level subcondylar fractures with adequate visibility and direct access to the condylar area.

scholarly journals Endoscopic-Assisted Intraoral Open Reduction Internal Fixation of Mandibular Subcondylar Fractures: Initial Experiences from a Tertiary-Care Maxillofacial Center in India

2018 ◽  
Vol 11 (3) ◽  
pp. 183-191 ◽  
Author(s):  
Venkatesh Anehosur ◽  
Abhijit Joshi ◽  
Saravanan Rajendiran
Keyword(s):  
Facial Nerve ◽  
Learning Curve ◽  
Internal Fixation ◽  
Open Reduction ◽  
Tertiary Care ◽  
Mouth Opening ◽  
Open Reduction Internal Fixation ◽  
Steep Learning Curve ◽  
Intraoral Approach ◽  
Condylar Fractures

Management of condylar fractures is a highly controversial and debatable area. Open reduction and internal fixation (ORIF) using an extraoral approach has certain benefits over the nonsurgical treatment. Risk of damage to the facial nerve and an extraoral scar remains constant deterrents. An endoscopic-assisted ORIF offers an intraoral approach, thus eliminating consequences such as scarring. Though this technique offers unparalleled advantages, it is associated with a steep learning curve. Surgical results improve only with patience and experience. Patients with condylar fractures reported to SDM Craniofacial Unit, Dharwad, India, from 2013 to 2015 are included. Patients were treated with endoscopic-assisted ORIF and were evaluated for functional outcomes that included occlusion, maximal interincisal opening, and deviation of mouth and complications such as facial nerve pareses, postsurgical infection, and morbidity. Fifteen patients included in the study: 4 left sided and 11 right sided fractures. Nine patients had associated other mandibular fracture. Mean age of the patients was 28.2 years. Mean mouth opening at the end of 1 week, 6 weeks, and 6 months was 32.6, 37.8, and 40.5 mm, respectively. Transient facial nerve pareses were noted in one patient, and an extraoral draining sinus was noted in another. Endoscopic-assisted ORIF has a definite scope in management of condylar fractures. Results are more predictable with appropriate case selection due to a steep learning curve and intraoperative technical challenges. An initial experience in ORIF using extraoral approaches would greatly benefit a surgeon in utilizing this novel and alternate tool.

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