Subcondylar osteotomy – case report

Abstract

Background: The fractures of the mandibular condyles are very controversial, regarding the diagnosis and mainly regarding the treatment. The classification used for condyle fractures is usually anatomical and divides them by the comprehension of the fracture tract (head, neck and subcondylar). Those fractures usually originate from indirect trauma and affect from 18% to 57% of mandibular fractures. Its etiology is represented by: automotive accidents, physical aggressions, falls, sports accidents, accidents at work, among others. Conservative treatment is used as first choice in condylar fractures because it is minimally invasive. However, when poorly indicated it may lead to secondary complications such as: poor bone healing, loss of posterior height, limiting mouth opening, anterior open bite, facial asymmetry, local pain, edema and temporomandibular ankylosis. Surgical treatment compared to conservative treatment has been shown to be more efficient. This treatment has been increasingly used by surgeons due to its prognosis and better postoperative recovery because it is recommended extra-oral accesses and rigid internal fixation. The use of subcondylar osteotomy was shown to be effective for correction of condylar fractures sequel, especially when associated with rigid internal fixation and its complications are the same as any surgical procedure for mandibular condyle fractures.