Open reduction and internal fixation of condylar fractures via an extended bicoronal approach with a masseteric myotomy

Abstract

Although condylar fractures of the mandible may be treated by closed reduction and appropriate physiotherapy, open reduction and internal fixation is indicated in specific circumstances. We report 25 cases of a previously unreported method of exposure of condylar fractures using an extended bicoronal approach combined with myotomy of the masseter muscle. Acceptable reduction and fixation was achieved in all cases with an early return to function. The incidence of complications was low, with three mild temporary facial palsies which had resolved by the sixth postoperative week and one haematoma beneath the bicoronal scalp flap. A cosmetically acceptable scar was produced in all cases. The excellent surgical exposure and protection of the facial nerve, combined with cosmetically acceptable scars, commend the use of this technique.