Comparison of three surgical approaches for fractures of the mandibular condyle

Abstract

Mandibular condylar process is the third most commonly fractured bone. Various surgical approaches to fix this condyle are described hitherto testify to the advantages and disadvantages of various surgical techniques used for approaching the condyle in such fracture cases. Here we have compared three such surgical techniques. Aim: The aim of this study was to compare the outcome of various surgical approaches for the treatment of condylar fractures. Materials and Methods: A retrospective study of 60 patients who were diagnosed with condylar fracture and required open reduction and internal fixation were considered. 59 cases were unilateral and 1 was bilateral. 60 patients were categorized into three groups of 20 each according to the surgical approach performed. All data were evaluated using the patient’s records including the radiological imaging. Parameters like post-op IMF, facial nerve injury, scar, wound infection, malocclusion and plate retrieval were noted. Results: The submandibular approach showed the worst outcome in terms of facial nerve injury, unfavorable scar, and wound infection. No significant differences between the pre-auricular and trans parotid approaches were detected in the above mentioned parameters. Post op infection was high in the pre auricular group. 10% of the cases in the pre auricular group had to undergo plate retrieval. Conclusion: Inferior neck condylar fractures benefit from submandibular approach, high neck fractures from trans parotid approach and condylar head fractures via preauricular approach. Keywords: Condylar fractures, Open reduction, Various surgical approaches.