Perhaps no area of facial trauma has inspired more controversy than the management of mandibular subcondylar fractures. Fractures of the condylar region. Clinically, this equates to open treatment of condylar neck fractures or subcondylar (caudal) fractures (A). The surgeon may elect to place one or two plates. Background and objective: Mandibular fractures are the most frequent and sub condylar region is a common site of fracture. Proper.

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The occlusion shows premature contact on the right with the deviation of the jaw to the affected side that is commonly seen with a right mandibular mandibbular fracture.

Mandibular Subcondylar Fractures: A Review on Treatment Strategies

It can also avoid direct contact with the facial nerve and manddibular the integrity of the parotid gland as well as its capsule and leaves a barely noticeable scar in a relatively hidden region [ 1 ]. Except in avulsive type injuries, or those where there might be airway compromise, a several day delay in the treatment of mandible fractures seems to have little impact on the outcome or complication rates.

Cochrane Database of Systematic Reviews 4: Open versus closed treatment of fractures of the mandibular condylar process-a prospective randomized multi-centre study. There are a multitude of various plate and screw combinations including compression plates, non-compression plates, lag-screws, mini-plates and biodegradable plates.

If the impact is in the midline fracturre the mandible, fractures of the bilateral condylar region are very common.

subconrylar To perform an open reduction and internal fixation, there must be room in the superior fragment for at least two screws fixing the same plate. As soon as the globular parotid tissue appears from the fascial incision, blunt dissection with a mosquito is used.

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This protocol is also applicable to bilateral fractures in which the fractured segments are not displaced.

International Journal of Oral and Maxillofacial Surgery. Authors using the endoscopic method to treat subcondylar fractures believe that a single intraoral incision would be sufficient to reduce a laterally displaced condyle.

Management of mandible fractures has been mentioned as early as B. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs Licensewhich permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no kandibular or adaptations are made. The skin and subcutaneous tissue are then closed.

Surgical Management of a Mandible Subcondylar Fracture

mamdibular General considerations Controversy has surrounded all aspects of fractures of the condylar process. Surgical versus conservative treatment of unilateral condylar process fractures: Sign in to customize your interests Sign in to your personal account. Therefore, the choice of surgical approach depends on the need to create an optimal view of the whole subcondyle without injury to the facial nerve or to the vascularization to the condylar head during surgery.

Please review our privacy policy. Received May 6; Accepted Jul Biomechanics Hunting bow concept The mandible is similar to a hunting bow in shape, strongest in the midline symphysis and weakest at both ends condyles. The force is transmitted from the body of the mandible mandbiular the condyle.

Any violation of the parotid gland capsule must be closed tightly to prevent salivary fistula.

Mandibular fracture

Previously, conservative management of condylar fractures was favored. Views included AP for parasymphsislateral oblique body, ramus, angle, coronoid process and Towne’s condyle views. Some publications, state no marked difference between the results of open or closed treatments 16fractuure — D The postoperative scar is hardly visible.

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Condylar injuries are often subjected to discussion and controversy in maxillofacial surgery as they constitute many of the facial fractures.

The proximal point of mahdibular incision is just below the ear lobe, runs parallel down to the posterior border of the mandible, and is limited to 25 mm in length.

skbcondylar Bilateral fractures with shortening and dislocation result in anterior open bite with minimal deviation of the midline. Even for lateral dislocations of the subcondylar area, an intraoral approach is suggested, due to the unperceptive scar, no matter how challenging it may be 40 Those approaches provide good visualization of the subcondyle from the posterior edge of the ramus, allow the surgeon to work perpendicularly to the fracture, and enable direct fracture management.

The skin incision of this approach is located just posterior to the mandibular ramus and the most proximal point of the incision is just below the ear lobe, runs parallel down to the posterior border of the mandible, and is limited to 25 mm in length Fig.

This article has been cited by other articles in PMC. Archived PDF from the original on