Management of mandibular condylar fractures by the retromandibular approach – An evaluation of its complications

2021 ◽  
Vol 12 (2) ◽  
pp. 80-85
Author(s):  
Devakumari Shanmugam ◽  
Neil Dominic ◽  
Vijhayapriya Thanasekaran ◽  
Amudha Purushothaman ◽  
Dinesh Sridhar ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Internal Fixation ◽  
Open Reduction ◽  
Treatment Plan ◽  
Mandibular Condyle ◽  
Mouth Opening ◽  
Mandibular Nerve ◽  
Clinical Parameters ◽  
Marginal Mandibular Nerve ◽  
Condylar Fractures

Background: Mandibular condyle fractures are commonly encountered in the practice of maxillofacial surgeon. Even though being a commonly seen fracture, the fracture condyle of the mandible demands meticulous diagnosis and a tailor made treatment plan for each and every patient. The treatment plan largely depends on the age of the patient and the displacement of the fractured fragment. This retrospective study provides an insight in to the management of fracture mandibular condyle by retromandibular approach. Aims and Objectives: The aim of this study was to evaluate the complications of the retromandibular transparotid approach in surgically operated patients with mandibular condylar fractures. Materials and Methods: A retrospective study was performed by analyzing the treatment records of patients who underwent open reduction and internal fixation (ORIF) by the retromandibular transparotid approach for seven years. Thirty-five patients who fulfilled the criteria were included in the study. Clinical parameters such as marginal mandibular nerve weakness, sialocele, occlusal derangement and decreased mouth opening were recorded during the first, fourth and twelfth weeks postoperatively. The retrieved data were analyzed for complications of the retromandibular approach in the management of mandibular condylar fractures. Results: In patients (N= 35) who underwent ORIF by the retromandibular transparotid approach, findings recorded at the end of the first week included 5 patients with sialocele, 2 patients with derangement of occlusion, 6 patients with restricted mouth opening and 1 patient with marginal mandibular nerve weakness. However, postoperatively, at the end of 4 weeks, the only complication observed was sialocele in 3 patients. Furthermore, at the end of 12 weeks, sialocele had completely resolved in all 3 patients, and they were free of complications. Conclusion: The retromandibular transparotid approach is a reliable and straightforward technique with manageable complications.

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 Retromandibular Approach as a Method for Open Reduction and Internal Fixation of Mandibular Condyle Fractures. Experience in the Regional Hospital 1º de Octubre, ISSSTE and Literature Review

2021 ◽  
Vol 7 (7) ◽  
Author(s):  
González MGR ◽  
Munguía AMN ◽  
González CASJ ◽  
Tellez EB ◽  
Montes IDG
Keyword(s):  
Internal Fixation ◽  
Closed Reduction ◽  
Open Reduction ◽  
Surgical Techniques ◽  
Mandibular Condyle ◽  
Middle Cranial Fossa ◽  
Sufficient Evidence ◽  
Mandibular Fractures ◽  
Open Treatment ◽  
Condylar Fractures

Mandibular condyle fractures constitute 17.5% to 52% of mandibular fractures. Open reduction with internal fixation and closed reduction are described for their treatment. Fonseca describes the absolute indications for open treatment when there is displacement of the mandibular condyle to the middle cranial fossa, foreign body invasion, extra capsular displacement of the condyle, and/or malocclusion not susceptible to closed reduction. It includes indications with vast evidence for open treatment of bicondyle fractures, condylar displacement greater than 45 degrees, reduction in the height of the mandibular ramus greater than or equal to 2mm, fractures associated with fractures of the middle third and when there is unstable occlusion. The above establishes sufficient evidence to perform open treatment in various situations of condylar fractures. Regarding the approach of the mandibular condyle region there are different surgical techniques, such as, the preauricular, retroauricular, submandibular, retromandibular, and rhytidectomy approaches.

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.

scholarly journals The role of open reduction and internal fixation in the treatment of the intercondylar fractures of humerus

2019 ◽  
Vol 5 (5) ◽  
pp. 855
Author(s):  
Venkata Sivaram G. V. ◽  
Y. V. S. Prabhakar
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Early Mobilization ◽  
Distal Humerus ◽  
Inclusion Criteria ◽  
Senior Faculty ◽  
Chevron Osteotomy ◽  
Stiff Elbow ◽  
Condylar Fractures

<p class="abstract"><strong>Background:</strong> Inter-condylar fractures represent one of the most complicated and challenging fractures in the upper extremity. The results of managing these fractures non-operatively are limited by failure to get anatomical reduction and early mobilization, which often results in painful stiff elbow and/or pseudo-arthrosis. The objective of this study was to evaluate and analyse the role of open reduction and internal fixation in inter-condylar fractures of distal humerus.</p><p class="abstract"><strong>Methods:</strong><strong> </strong>The present study was done in Malla Reddy Institute of Medical Sciences between June 2014 and June 2017. Out of 34 cases of intercondylar fractures of humerus admitted during the period, 25 patients were selected for the study that satisfied our inclusion criteria. Three patients out of those selected could not be included in the study as one had cardiac issues pre-operatively, one refused surgery and one was lost to follow up.<strong></strong></p><p class="abstract"><strong>Results:</strong> Our study included 22 patients, 14 male and 8 female patients. Their average age was 41.4 years. The fractures were classified as per the AO classification. There were B1-3, B2-1, C1-6, C2-5, C3-7 fractures. Both compound and closed fractures were included. All the patients were operated by posterior olecranon Chevron osteotomy approach by a senior faculty member. Twenty two patients who satisfied our inclusion criteria were treated, followed up and the results analyzed using Cassabaum’s scale of elbow function we had 86% of excellent to good results. Our results are comparable with other similar studies.</p><p class="abstract"><strong>Conclusions:</strong> Posterior olecranon approach was found to be of most satisfactory approach by us. It allows good exposure of the joint and the ulnar nerve.</p>

Open Reduction and Internal Fixation of Fractures of the Acebabulum - Retrospective Study of 21 Consecutive Cases -

1996 ◽  
Vol 31 (1) ◽  
pp. 110 ◽  
Author(s):  
Weon Yoo Kim ◽  
Jin Hyung Sung ◽  
Chong Hoon Park ◽  
Jin Wha Chung ◽  
Jin Young Kim
Keyword(s):  
Retrospective Study ◽  
Internal Fixation ◽  
Open Reduction

scholarly journals Evaluation of open reduction and internal fixation of proximal humerus fractures using a locking plate with smooth pegs – A retrospective study

2018 ◽  
Vol 11 (6) ◽  
pp. 411-418
Author(s):  
Frida Hansson ◽  
Magdalena Riddar ◽  
Anders Ekelund
Keyword(s):  
Quality Of Life ◽  
Retrospective Study ◽  
Internal Fixation ◽  
Avascular Necrosis ◽  
Open Reduction ◽  
Locking Plate ◽  
Constant Score ◽  
Humeral Fracture ◽  
The Mean

Background Optimal treatment of displaced proximal humeral fractures is controversial. This retrospective study aims to identify complications and clinical outcomes using a locking plate with smooth pegs instead of screws (S3 plate). Method Eighty-two patients with displaced proximal humeral fracture classified with 2–4 fragments (Neer’s classification) treated with open reduction and internal fixation (ORIF) with S3 plate were studied retrospectively. Clinical outcome according to constant score; Single Shoulder Value; Disabilities of Arm, Shoulder and Hand; and European Quality of life-5 dimensions and complication rate defined radiologically including peg penetration, avascular necrosis, and loss of reduction was assessed minimum 2.5 years after surgery. Results A total of 11 peg penetrations were identified (13.6%). Avascular necrosis was seen in 8.5% (n = 7). Mean constant score at follow-up was 64.4 with a relative constant score of 87% (standard deviation 18%) compared to the contralateral uninjured side. The mean Disabilities of Arm, Shoulder and Hand score was 12.7 and mean European Quality of life-5 dimensions score 0.83. The mean Single Shoulder Value was 78.3. No cases of deep infection were seen. Conclusions Fixation with S3 plate shows a proper osteosynthesis and the functional outcome is good. Symptomatic peg penetrations are rare and the incidence is lower compared to what has been reported with locked screws.

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