Open reduction and internal fixation of low subcondylar fractures of mandible through high cervical transmasseteric anteroparotid approach

J Oral Maxillofac Surg. 2009 Nov;67(11):2446-51. doi: 10.1016/j.joms.2009.04.109.

Abstract

Purpose: The aim of the present study was to evaluate the functional and radiologic results of low subcondylar fracture fixation with modus TCP plates (Medartis, Basel, Switzerland) using a high cervical transmasseteric anteroparotid approach.

Materials and methods: A prospective study was designed, enrolling all minimum-aged 15-year-old echomorphology patients presenting with displaced low subcondylar fracture with occlusion disturbances during a 41-month period. All fractures were fixed with modus TCP plates using high cervical transmasseteric anteroparotid approach. All patients underwent immediate physiotherapy and a 6-week liquid and semiliquid feeding period. Clinical and radiologic examinations were performed at 1 week and 1, 3, and 6 months. A total of 35 patients presenting with 38 fractures were enrolled with a mean follow-up of 17 months.

Results: All fractures had healed at 6 months in the correct anatomic position in 73.7%. Occlusion was deemed normal in 80% of the patients. The mandibular movement was normal in 97.1%, with the mouth opening up to 40 mm, mean lateral movement of 11 mm without a difference between the 2 sides, and a mean protrusion of 12 mm. Minimal asymmetry remained in 15.6%. No facial palsy occurred, including no transient facial palsy. Complications consisted of 1 infection and 1 plate fracture requiring surgical revision.

Conclusions: Low subcondylar fracture fixation with modus TCP plates using a high cervical transmasseteric anteroparotid approach is a safe and reproducible procedure providing excellent functional results. This procedure has been routinely performed in our department.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Bone Plates
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Fracture Fixation, Internal / instrumentation
  • Fracture Fixation, Internal / methods*
  • Humans
  • Male
  • Mandibular Condyle / injuries
  • Mandibular Condyle / surgery*
  • Mandibular Fractures / surgery*
  • Masseter Muscle / surgery
  • Middle Aged
  • Oral Surgical Procedures / methods*
  • Orthopedic Procedures / methods
  • Parotid Gland
  • Prospective Studies
  • Range of Motion, Articular
  • Recovery of Function
  • Temporomandibular Joint / injuries
  • Temporomandibular Joint / surgery
  • Treatment Outcome
  • Young Adult