Simplified Method for Reduction of Displaced Condylar Head Fracture Using a Monocortical Screw.

Abstract

Condylar head fractures is difficult to treat because of medial displacement caused by muscle pull and limited access to visualize the proximal segment and secure them back to anatomic position. A novel technique is proposed to overcome the difficulties and ease the task of a surgeon. The main goal in Open reduction and internal fixation is to achieve anatomical position and establish occlusion, a task possible only after securing the segment back into place. Over decades, many authors have described various techniques to ease the task yet surgeons are forced to treat cases using closed technique which adds limitation to the rehabilitation of stomatognathic system for a prolonged time. Self holding screw driver, 1.5x10mm monocortical screws and drill bit. Using any preauricular access incision, dissection is proceeded anteromedially and the medial segment is identified. A drill hole is made with 1.2 mm diameter drill with counter using periosteal retractor, monocortical screw fixed and segment secured using a self-holding driver and lateralized after increasing the joint space thus achieving the original retromandibular height. The treatment outcomes are better achieved with ease to surgeon and with minimal armamentarium without any special needs per se. The technique proposed is novel and can help achieve desired outcomes even in hands of budding surgeon with minimal time and efforts invested.