Retromandibular approach in the management of condylar fractures by open reduction and internal fixation a prospective study

Kshirsagar, Rajesh; Singh, Vikram; Pawar, Sudhir; Shah, Rahul Hemant

doi:10.4103/0975-5950.183852

Cited by 12 publications

(6 citation statements)

References 9 publications

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“…The small incision size and the height (higher level) of the intra-articular condylar head fracture make it a difficult task to reach and reduce the segments. The main reason for considering this approach as one of the choices in the management of diacapitular fractures is the lower risk of facial nerve injury as well as the most conservative of the condylar approaches in the context of soft tissue handling [ 16 ]. In the modified retromandibular approach, the area in the middle of the buccal and marginal mandibular branch of the facial nerve is utilized for dissection, thereby ensuring the protection of the facial nerve and preventing additional morbidity.…”

Section: Discussionmentioning

confidence: 99%

Modified Retromandibular Approach for the Management of Condylar Fractures of the Mandible

Bhat¹,

Krishna²,

Periasamy³

et al. 2022

Cureus

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Condylar fractures of the mandible have been of particular interest to surgeons for decades, as there is a big debate regarding the management option: conservative versus surgical modality. Conservative treatment is the preferred treatment modality for condylar head (diacapitular) fractures. Currently, surgical modality is favored and surgeons are opting for open reduction and internal fixation for diacapitular fractures as it reestablishes the anatomical position of the fragments and disc, and permits immediate functional mobility of the jaw, thereby reducing the chances of occurrence of temporomandibular joint ankylosis. This case series enumerates the pros and cons of open reduction and internal fixation of condylar fractures of the mandible occurring at various levels using a modified retromandibular approach and highlights that this can be considered as one of the treatment options for condylar fractures.

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Section: Discussionmentioning

confidence: 99%

Modified Retromandibular Approach for the Management of Condylar Fractures of the Mandible

Bhat¹,

Krishna²,

Periasamy³

et al. 2022

Cureus

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“…Salivary fistula is a potential complication which can be prevented by watertight closure of the parotid capsule. 23 In our study, in 2 cases salivary fistula was observed which was treated by antisialagogues (Tab. Glycopyrrolate 1 mg, BD) for 7 days.…”

Section: Stability Of Fractured Fragment and Osteosynthesis Devicementioning

confidence: 58%

Comparative evaluation of open reduction and internal fixation using delta plate versus conservative treatment in management of mandibular subcondylar fractures in adults

Bhavsar

Patel²,

Pandya³

et al. 2023

JOOO

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The aim of the evaluative study was to compare the efficacy of standard conservative treatment and the open reduction internal fixation (ORIF) using the delta titanium plates in the mandibular subcondylar fractures in adults. Patients who diagnosed with mandibular subcondylar fracture in the department from January 2018 up to September 2019 were recruited into the study. The patients satisfying the inclusion criteria were randomly assigned to two groups in a 1:1 ratio (10 in each group). Group A comprised patients treated using delta titanium plates through open reduction and internal fixation and Group B comprised patients treated with closed reduction. Informed consent was taken for all the patients. All the patients of Group A underwent ORIF under GA via retromandibular approach. Pain was significantly higher in 1 and 3 month follow up in group B compared to group A. Comparison of mouth opening in both the groups show statistically significant difference at 3 and 6 month compared to baseline mouth opening. Deviation was more prevalent at 1 and 3 month follow up in group B compared to group A. Presence of mandibular deviation at 1, 3 and 6 month was statistically insignificant for both the groups.Our experience with 3D stable delta plate provides better treatment outcomes in terms of easy adaptation to the anatomy of the fracture site, better 3D stability and functional osteosynthesis.

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“…[ 28 ] Other benefits include good cosmesis and adequate exposure for manipulation and reduction of the fracture and for placement of fixation in condylar neck and subcondylar fractures. [ 29 30 ] Retromandibular approach is an effective and safe technique, especially for displaced subcondylar fractures. [ 31 ]…”

Section: Discussionmentioning

confidence: 99%

The retromandibular transparotid approach for reduction and internal fixation of mandibular condylar fractures

Felix

Singh

2020

Ann Maxillofac Surg

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Introduction: The retromandibular transparotid approach is most useful for condylar and subcondylar fractures and provides the best access to the joint and ascending ramus. The study aims at evaluating the ease of access and outcomes encountered on using the retromandibular transparotid approach to access the fracture site for the open reduction and internal fixation (ORIF) of condylar and sub-condylar fractures. Materials and Methods: An observational clinical study was carried out among 10 patients with unilateral and bilateral condylar fracture requiring ORIF. Maximal interincisal mouth opening, facial swelling, occlusal discrepancy, facial nerve injury, scar formation, and acceptability and complications including wound dehiscence, infection, and sialocele/salivary fistula were assessed and measured preoperatively and postoperatively. Results: There was a notable improvement in mouth opening and facial nerve weakness. Postoperative intermaxillary fixation was done with selective patients who had a discrepancy in their occlusion. Preoperatively, swelling was present in four patients (40%) out of 10 patients studied. There was no incidence of sialocele/salivary fistula in any of the cases studied. Conclusion: Retromandibular transparotid incision is technique sensitive and thorough knowledge about the retromandibular area is must for good results and minimal morbidity. The cosmetic results are good in this approach, as well as the facial nerve injury were less in this without any permanent damages.

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Retromandibular approach in the management of condylar fractures by open reduction and internal fixation a prospective study

Cited by 12 publications

References 9 publications

Modified Retromandibular Approach for the Management of Condylar Fractures of the Mandible

Modified Retromandibular Approach for the Management of Condylar Fractures of the Mandible

Comparative evaluation of open reduction and internal fixation using delta plate versus conservative treatment in management of mandibular subcondylar fractures in adults

The retromandibular transparotid approach for reduction and internal fixation of mandibular condylar fractures

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