Condylar Neck Fractures Research Articles

Deferoxamine Accelerates Mandibular Condylar Neck Fracture Early Bone Healing by Promoting Type H VesselProliferation.

Condylar fractures (CFs) are a common type of maxillofacial trauma, especially in adolescents. Conservative treatment of CF avoids the possible complications of surgical intervention, but prolongs the patient's suffering because of the requirement for extended intermaxillary fixation. Therefore, the development of a new strategy to accelerate the rate of fracture healing to shorten the period of conservative treatment is of great clinical importance. To investigate the potential of deferoxamine (DFO) in promoting the healing process of CF in adolescent mice. Thirty-two 4-week-old male C57BL/6J mice were randomly assigned to four groups: vehicle + sham group, vehicle + CF group, DFO + sham group and DFO + CF group. After constructing the mandibular CF model, mandibular tissue samples were collected respectively at 1, 2 and 4 weeks postoperatively. Radiographic and histomorphometric analyses were employed to assess bone tissue healing and vascular formation. Deferoxamine was observed to promote the early bone healing of fracture, both radiologically and histomorphometrically. Furthermore, this enhancement of condylar neck fracture healing was attributed to the upregulation of the hypoxia-inducible factor-1α (HIF-1α) signalling pathway while facilitating the formation of type H vessels. In addition, DFO did not produce significant effects on the condylar neck between vehicle + sham and DFO + sham group. The application of the HIF-1α inducer DFO can enhance type H vessels expansion thereby accelerating condylar neck fracture healing.

Electromyographic Study of Facial Nerve Function Using Two Different Surgical Approaches in Low Condylar Fractures of the Mandible: A Randomized Controlled Clinical Trial

Facial nerve (FN) dysfunction is a potential complication during open reduction of mandibular condylar fractures. The purpose of this study was to measure and compare the postoperative FN function following transparotid (TP) and transmasseteric anterior parotid (TMAP) operative approaches in open reduction and internal fixation of condylar fractures using electromyogram. A randomized controlled clinical trial was designed. The study was conducted in a single tertiary-care hospital in the inpatient setting. Patients aged above 18years with unilateral condylar fracture of the jaw or bilateral condylar fractures undergoing surgery on only 1 side were included. Patients were excluded if they had fractures of the head, bilateral condylar fractures with surgery planned on both sides, a previous history of surgery in the retromandibular area, existing lacerations to approach condyle, preoperative signs of FN weakness, or a history of parotid surgery. The predictor variable was the operative approach and the subjects were allocated randomly to TMAP and TP. The primary outcome variable was postoperative FN function in the surgical approach employed using the House-Brackmann scale and electromyography (EMG) to record any subtle weakness in nerve function. The FN function is recorded at 3 time intervals postoperatively 1week (T1), 1month (T2), and 3months (T3). The secondary outcomes studied were operating time and any other complications recorded. Age, sex, fracture pattern with classification of condylar fractures into condylar neck or base fractures according to Loukata etal.4 Any associated fracture of mandible describing the anatomical location viz symphysis and parasymphysis (anterior mandible), body, contralateral condyle or greater than 1 associated fracture were recorded. Similarly, the presence or absence of any associated midface fracture was also recorded to suggest that the study participants were homogenous in all aspects. Analytical statistics included χ2 test, t-test, and repeated measures ANOVA followed by post hoc test to compare EMG data (mean power and mean amplitude) between 2 operative approaches (TP vs TMAP) for facial muscles including frontalis, oculi, and buccinator at different time intervals (T0, T1, T2, T3). Patients within each group were also analyzed to check for nerve recovery occurring during the follow-up period. The level of significance was set at P<.05. The study sample was composed of 22 patients with a mean age of 32.82±11.21years in TMAP and 27.82±8.54years in the TP group respectively (P=.26); male predominance of 81.8 and 90.9% in TMAP and TP group respectively (P=.53) was noted. The FN deficit as assessed by the House-Brackmann scale clinically, was at 54% (T1), 36.4% (T2), and 9.1% (T3) for the TP group and 27% (T1),9% (T2), and 0% (T3) for TMAP group; however, the results were statistically insignificant (P=.31). In surface EMG evaluation, the mean power for the frontalis muscle was significantly higher in the TMAP approach at the T3 time (105.03±9.7 vs 89.56±10; 95% confidence interval -24.28 to -6.65 with P value=.002). TP approach was faster with a mean exposure time of 9.9minutes. The results show that both approaches give comparable long-term results with the TMAP group showing better frontalis muscle activity.

Transoral endoscopic assisted reduction and internal fixation of mandibular condylar neck fractures with short condylar segment

This study aimed to assess the reliability and safety of transoral endoscopic-assisted reduction internal fixation (TERIF) for treating short-segment condylar neck fractures (CNF), including hardware removal.Patients with displaced CNF and short condylar segments treated using TERIF were included in the study. Clinical evaluation covered dental occlusion, range of mouth opening, deviation during mouth opening, protrusion, laterotrusion, pain, and chewing. Radiological evaluation was used to assess fracture displacement, angulation, head dislocation, postoperative reduction, fixation stability, and bone healing. The same technique was used to treat 15 patients with 18 CNF and short condylar segments. Hardware removal was performed for nine fractures in eight patients after fracture healing using the same approach.All patients regained satisfactory, pain-free mouth opening with no deviation and complete bone healing. Computed tomographic images displayed adequate reduction and stable fixation during the follow-up period for all patients. No temporary or permanent facial nerve impairment occurred in any of the patients.TERIF is a reliable and safe treatment for CNF with short condylar segments, even in the presence of head dislocation, medial override, and malunited fractures; hardware can be safely removed after healing using the same approach.

Detection and classification of mandibular fractures in panoramic radiography using artificial intelligence.

This study aimed to assess the performance of a deep learning algorithm (YOLOv5) in detecting different mandibular fracture types in panoramic images. This study utilized a dataset of panoramic radiographic images with mandibular fractures. The dataset was divided into training, validation, and testing sets, with 60%, 20%, and 20% of the images, respectively. An equal number of control panoramic radiographs, which did not contain any fractures, were also randomly distributed among the three sets. The YOLOv5 deep learning model was trained to detect six fracture types in the mandible based on the anatomical location including symphysis, body, angle, ramus, condylar neck, and condylar head. Performance metrics of accuracy, precision, sensitivity (recall), specificity, dice coefficient (F1 score), and area under the curve (AUC) were calculated for each class. A total of 498 panoramic images containing 673 fractures were collected. The accuracy was highest in detecting body (96.21%) and symphysis (95.87%), and was lowest in angle (90.51%) fractures. The highest and lowest precision values were observed in detecting symphysis (95.45%) and condylar head (63.16%) fractures, respectively. The sensitivity was highest in the body (96.67%) fractures and was lowest in the condylar head (80.00%) and condylar neck (81.25%) fractures. The highest specificity was noted in symphysis (98.96%), body (96.08%), and ramus (96.04%) fractures, respectively. The dice coefficient and AUC were highest in detecting body fractures (0.921 and 0.942, respectively), and were lowest in detecting condylar head fractures (0.706 and .812, respectively). The trained algorithm achieved promising performance metrics for the automated detection of most fracture types, with the highest performance observed in detecting body and symphysis fractures. Machine learning can provide a potential tool for assisting clinicians in mandibular fracture diagnosis.

A single-centre retrospective 10-year experience of the rhombic 3D condylar fracture plate for open reduction and internal fixation of condylar neck and base fractures

Fractures of the mandibular condyle account for a significant proportion of mandibular fractures. The specific functional loads require particular specifications for the implant design used for open reduction and internal fixation of such fractures. The clinical and radiographic outcomes in patients treated using a single rhombic 3D condylar fracture plate for open reduction and internal fixation at a single institution, and who fulfilled the inclusion and exclusion criteria, are presented.The primary outcome variables were: occlusion, maximum interincisal distance and mandibular excursion at 1, 3, and 6 months postoperatively, and radiographic measurements for mandibular height and gonion angle.In total, 263 patients were included, of whom 173 (65.8%) were male and 90 (34.2%) female. The mean age was 40.4 ± 18.9 years. There was satisfactory occlusion in 98.9% of patients at the 6-month follow-up, and a significant improvement in all parameters for mandibular excursion (p < 0.001), with a reduced ramus height and an increase in the gonion angle on the fractured side.Excellent clinical and radiographic results were achieved using the rhombic-shaped implant, deeming it appropriate for the osteosynthesis of mandibular condyle fractures.

Temporomandibular joint degenerative changes following mandibular fracture: a computed tomography-based study on the role of condylar involvement.

This study assessed the incidence of postfracture radiological temporomandibular joint (TMJ) degeneration in patients with different types of mandibular fractures, focusing on the impact of condylar fractures. This retrospective review included patients diagnosed as having mandibular fractures from 2016 to 2020 who had undergone initial computed tomography (CT) and a follow-up CT scan at least 1-month postfracture. Patient demographics, fracture details, treatment methods, and radiological signs of TMJ degeneration on CT were analyzed to identify risk factors for postfracture TMJ degeneration, with a focus on condylar head fracture and non-head (condylar neck or base) fractures. The study included 85 patients (mean age: 38.95 ± 17.64years). The per-patient analysis indicated that the incidence of new radiologic TMJ degeneration on CT was significantly the highest (p < 0.001) in patients with condylar head fractures (90.91%), followed by those with non-head condylar fractures (57.14%), and those without condylar involvement (24.49%). The per-joint analysis indicated nearly inevitable degeneration (93.94%) in 33 TMJs with ipsilateral condylar head fractures. For the remaining 137 TMJs, multivariate logistic regression revealed that other patterns (ipsilateral non-head, contralateral, or both) of condylar fractures (odds ratio (OR) = 3.811, p = 0.007) and the need for open reduction and internal fixation (OR = 5.804, p = 0.005) significantly increased the risk of TMJ degeneration. Ipsilateral non-head condylar fractures and contralateral condylar fractures are associated with a high risk of postfracture TMJ degeneration. Indirect trauma plays a vital role in postfracture TMJ degeneration.

Correlating assessment between clinical features and morphologies on CT scan of mandibular condyle fracture

Background: Among mandibular fractures, condyle fractures are common injuries which directly affect the occlusal function and aesthetics of the patients. Accurate diagnosis based on clinical and radiographic features helps to choose the appropriate treatment. This study aims to evaluate clinical features, morphologies on CT Scan of mandibular condyle fractures and analyze the relationship between these characteristics. Materials and methods: A cross-sectional study on 30 patients with mandibular condyle fractures were conducted at Department of ENT - Ophthalmology - Odonto Stomatology in the Hospital of Hue University of Medicine and Pharmacy, from December 2021 to June 2023. Results: The male:female ratio was about 2:1, the main cause of fractures was traffic accidents (73.4%). The common clinical symptoms were malocclusion (96.7%) with occlusal interferences on posterior teeth and limited mouth opening (83.3%). On CT Scan, condylar neck fractures were the most common position (58.8%). There was a relationship between the side of deviated mouth opening and the affected sides (p &lt; 0.05). In cases of unilateral condyle fractures, there was a relation between the side of premature contact on posterior teeth and the affected sides (p &lt; 0.05). Conclusions: Fractures of condylar neck was the most common fractures in the mandibular condyle, which resulted in malocclusion, interferences on posterior teeth, limited and deviated mouth opening. There was a relationship between deviated mouth opening and premature contacts on posterior teeth with the fractured side. Key words: Mandibular condyle fracture, clinical features, CT Scan.

How good is good enough? Lessons learned from review of outcomes of 50 patients following extraoral open reduction and internal fixation of condylar neck and base fractures at a regional major trauma centre

The management of mandibular fractures is routine owing to their frequency, particularly those of the mandibular condyle, which are invariably common. Notwithstanding disparities in the literature, the international consensus towards which fractures of the mandibular condyle benefit from open surgical intervention is almost universally accepted. Closed reduction or non-operative management may be utilised in certain circumstances. Whilst outcome research has addressed complications with respect to operative side effects, outcomes related to the quality of bone repair and the setting in which this is delivered have not been universally addressed. The aim of this study was to determine the predictability of translating an indicated operative treatment plan into an acceptable functional result. We evaluated the outcomes of 59 extracapsular condylar fractures in 50 patients who were treated by extraoral open reduction and internal fixation (ORIF) between March 2021 and August 2022. We reviewed demographic data, surgical approach, and plating strategy, and critically evaluated the clinical and radiological outcomes. Whilst we found that the quality of reduction was not universally perfect, the majority were within tolerance, which we set according to the Strasbourg Osteosynthesis Research Group (SORG) definition for minimal displacement (<2 mm overlap and 10° angulation). The cohort had good functional occlusion and minimal long-term postoperative complications. Two patients required re-operation for non-union, and we discuss causality in these cases. In conclusion, we found that ORIF of condylar neck and base fractures is predictable in real-time surgical practice with respect to functional outcome. However, if imperfectly reduced, there is a small risk of non-union.

Modified Preauricular Transparotid Approach for Treating Mandibular Condylar Fractures.

We introduce a technical variant of the standard preauricular approach to treat intracapsular and condylar neck fractures: the modified preauricular transparotid approach (MPTA). The main modification, when compared with the conventional submandibular approach, is that the incision of the superficial musculoaponeurotic system is performed directly above the parotid gland, and the buccal branch of the facial nerve is dissected in a retrograde way within the parotid gland. Between January 2019 and December 2020 at the Maxillofacial Departments of "Ospedale Maggiore" of Parma and "Policlinico San Martino" of Genoa 6 patients affected by intracapsular and condylar neck fractures underwent open reduction and internal with MPTA. Surgery was uneventful in all patients; no infections occurred in any of the cases; the mean procedure duration was 85 minutes, ranging from 75 to 115 minutes. At the 1-year follow-up, all patients had stable occlusion with a natural, well-balanced morphology of the face and adequate dynamic excursion of the mandible. MPTA is particularly suited for intracapsular and condylar neck fractures. Morbidity is negligible in terms of damage to the facial nerve, vascular injuries, and esthetic deformity.

Postoperative Complications following Open Reduction and Rigid Internal Fixation of Mandibular Condylar Fracture Using the High Perimandibular Approach.

The high perimandibular approach is a feasible surgical technique for treating mandibular condylar fractures with open reduction and internal fixation, followed by fewer complications. Temporary trismus is the only postoperative complication that may occur. This study evaluated postoperative complications following open reduction and rigid internal fixation (OR-IF) of mandibular condylar fractures using the high perimandibular approach. Twenty consecutive patients undergoing OR-IF were included in this study. They included 11 male and 9 female patients, of an average age of 58.5 years, all of whom responded to a follow-up call at least 12 months after the surgery. All patients were evaluated for range of mouth opening, postoperative complications, and radiological findings. A statistical analysis of the relationship between range of mouth opening and related clinical parameters at 6 months postoperative evaluation was conducted. The fracture of the condylar neck was associated with a limited range of mouth opening and longer operation time. However, longer operation time was not associated with a limited range of mouth opening. The high perimandibular approach with OR-IF in mandibular condylar fractures is a feasible and safe technique; however, prolonged surgery and mandibular condylar neck fractures could affect the postoperative range of mouth opening.

Surgical approaches of condylar fracture management - A Mini Review

Mandibular condylar neck and subcondylar fractures are common in maxillofacial surgery. The justification for surgical treatment of these fractures has varied over time, to avoid the most concerning side event, namely facial nerve injury. We offer a new approach that combines intraoral and cutaneous pre-auricular access, allowing for quick and safe access to the surgical site while avoiding facial nerve injury and surgical scars in high-impact aesthetic areas of the neck. Five patients with condylar neck or subcondylar fractures were treated at the same hospital using a combined intraoral and pre-auricular approach. Three months following surgery, the results were assessed in terms of mandibular mobility, complications, and patient satisfaction All five patients had a positive outcome, with complete fracture healing and no sequelae, including no facial nerve palsy. The safe reduction of the two mandibular pieces achieved by a combined intraoral and cutaneous pre-auricular surgical access is a major element of the approach. The periosteal plan of the ramus can be broadly and safely elevated using the intraoral approach and connected to the condylar bone plane with the pre-auricular cutaneous approach, avoiding facial nerve damage. The wide ramus periosteum elevation generates an "optical space" that allows fragment reduction and fixation in direct oblique view without the requirement for endoscopic intervention. Our findings strongly imply that with our technique, it is possible to treat sub-condyle and condylar neck fractures safely while avoiding facial nerve injury, which is an undesirable consequence due to its severe impact on quality of life.

106. Review of outcomes following extraoral Open Reduction Internal Fixation (ORIF) condylar neck and base fractures 2021-present. Our experience at a regional trauma centre

106. Review of outcomes following extraoral Open Reduction Internal Fixation (ORIF) condylar neck and base fractures 2021-present. Our experience at a regional trauma centre

96. Pseudoaneurysm of the Superficial Temporal Artery: A previously unreported complication of the pre-auricular approach

Pseudoaneurysms of the superficial temporal artery (STA) are reported as a rare complication of blunt craniofacial trauma and neurosurgical procedures. Classically they present with a pulsatile temporal swelling and are usually treated by surgical resection plus ligature of the proximal and distal vessel ends. We report the management of an unusual presentation of a pseudoaneurysm of the STA following open reduction and internal fixation (ORIF) of a high condylar neck fracture via pre-auricular approach.

Modified high-submandibular appraoch for open reduction and internal fixation of condylar fracture: case series report.

Recently a modified high-submandibular approach (HSMA) has been introduced for treatment of condylar fracture. This approach involves an incision line close to the mandibular angle and transmasseteric transection, leading to a low incidence of facial palsy and allowing good visualization of the condyle area, especially the condylar neck and subcondyle positions. This study reports several cases managed with this modified HSMA technique for treating condylar fractures. Six cases of condylar fractures treated with modified HSMA technique were reviewed. Three unilateral subcondylar fracture, 1 bilateral subcondylar fracture, 1 unilateral condylar neck fracture, 1 unlateral simultaneous condylar neck and subcondylar fracture cases were reviewed. All the cases were successfully treated without any major complication. Reduction, fixation, and osteosynthesis of condylar fractures via the modified HSMA technique enabled effective and stable treatment outcomes. Therefore, the described approach can be used especially for subcondylar and condylar neck fractures with minimal complications.

Quantitative Three-Dimensional Computed Tomography Measurements Provide a Precise Diagnosis of Fractures of the Mandibular Condylar Process.

As 2D quantitative measurements are often insufficient, a standardized 3D quantitative measurement method was developed to analyze mandibular condylar fractures, and correlate the results with the mandibular condylar fracture classifications of Loukota and Spiessl and Schroll and clinical parameters. Thirty-two patients with a unilateral mandibular condylar fracture were evaluated using OPT, 2D (CB)CT images, and 3D imaging to measure the extent of the fractures. The maximum mouth opening (MMO) was measured. Ramus height loss could be measured only in OPT, but not in 2D CT images. The Intraclass Correlation Coefficient was excellent in the 3D measurements. In the Loukota classification, condylar neck fractures had the largest median 3D displacement and the highest rotations of the fracture fragments. The largest fracture volume was observed in base fractures. According to the Spiessl and Schroll classification, type V fractures had the largest median 3D displacement and the highest rotation in the X-axis and Z-axis. Type I fractures had the largest fracture volume. We found a moderate negative correlation between MMO and 3D displacement and rotation on Z-axis. The 2D quantitative analysis of condylar fractures is limited, imprecise, and not reproducible, while quantitative 3D measurements provide extensive, precise, objective, and reproducible information.

Clinical Application of Digital Joint Guide in the Fracture of the Condyle Neck.

The purpose of this study is to use a digital guide plate for joint positioning to assist the reduction of condylar neck fractures and evaluate the accuracy of the reduction after surgery. In this study, 20 patients were selected from January 2016 to October 2020, and the reduction of the mandibular condyle neck fracture was designed virtual and digital based on the computed tomography data of the patients, based on the position of the condyle in the articular socket, the height of the ascending mandibular ramus, and the joints. The average value of the anterior space and the posterior space of the joint is these indicators, the position of the condyle is reconstructed, and the fracture reduction finger guide plate is designed. During the operation, the digital guide plate is used to assist the reduction of the condyle neck fracture. The postoperative follow-up was 4 to 12 months to check the accuracy of the reduction. A total of 20 patients, all fractures achieved complete bone healing, the patients' mouth opening was normal, no obvious complications were found, and none of the patients had facial paralysis. In the postoperative evaluation and preoperative virtual design plan, the chromatographic error was within 2mm, and the magnetic resonance of the temporomandibular joint showed no displacement of the articular disc. The digital joint guide can reduce the fracture of the condyle neck while ensuring the position of the condyle in the joint socket, which is beneficial to reduce the occurrence of subsequent temporomandibular joint complications.

EVALUATION OF THE TREATMENT OF MANDIBULAR CONDYLE FRACTURES THROUGH 95 CASES

Objective: To evaluate the treatment results of mandibular condylar fractures for prescription of more appropriate treatment methods. Methods: This is a retrospective and prospective cross-sectional study with follow-up on 95 patients treated for mandibular condylar fractures at 108 Central Military Hospital from January 2018 to October 2021. Results: A total of 95 condylar fractures were observed, including 75 unilateral fractures and 20 bilateral fractures. The most common fracture locations are: low condylar neck 53/115 (46.1%), condylar head 27/115 (23.5%), high condylar neck 22/115 (19.1%), subcondylar 13/115 (11.3%). Little deviation 13/115 (11.3), average deviation 79/115 (68.7%), high deviation 23/115 (20%). Conservative treatment for 18/115 condyle with good and satisfactory results accounted for 89.3%. Surgical removal of 33/115 condyles with good and satisfactory results accounted for 89.3%. Fracture osteosynthesis for 64/115 condyles with good and satisfactory results accounted for 96.2%. Conclusion: Conservative treatment should be indicated for cases with small or no displacement and condylar removal surgery for cases of condylar fractures or multi-fragment high condylar fractures with moderate and high displacement. The indication of osteosynthesis for low condylar neck and subcondylar fractures will have a high success rate.

Long-term masticatory performance and ability following closed treatment for unilateral mandibular condylar neck or base fractures: a cross-sectional study

PurposeThe aim of this study was to find explanatory variables for objective and patient-reported long-term masticatory functioning in patients treated with maxillomandibular fixation for unilateral condylar neck or base fractures. These outcomes were compared to healthy control subjects.MethodsPatients treated between 1996 and 2013 were enrolled in the study. Objective measurements included the mixing ability test (MAT) for masticatory performance, and range of motion of the mandible. Patient-reported measurements included the mandibular function impairment questionnaire (MFIQ) for masticatory ability, and the visual analogue scale for pain. Healthy subjects were recruited between October 2018 and January 2019, and performed the MAT and MFIQ.ResultsTwenty-one patients and 30 healthy subjects were included. The average follow-up period was 11.67 years. In adjusted regression analysis, the amount of occlusal units (OU) was associated with the MAT (P = 0.020; R2 = 0.253) and MFIQ (P = 0.001, R2 = 0.454). The MAT outcome was similar in both groups when correcting for OU (P = 0.001; R2 = 0.201). The MFIQ was inferior in the patient group (P = 0.001).ConclusionLong-term masticatory performance was similar in patients with a history of condylar neck or base fracture and healthy subjects; however, masticatory ability was inferior in patients compared to healthy subjects.

Application of the lambda plate on condylar fractures: Finite element evaluation of the fixation rigidity for different fracture patterns and plate placements

Purpose: The treatment challenges of condylar fractures necessitated the production of several plate designs. Among the relatively new plate designs is the lambda plate, for which biomechanical and clinical data are lacking. The purpose of this study is to examine the rigidity of fixation achieved when the lambda plate is applied to different fractures of the condylar neck and base.Methods: Five fractures of the condylar area were designed on a virtual model of a healthy mandible obtained from a CT scan. The fractures were reduced using the lambda plate. For the same fractures, alternative placements of the plate were simulated. The generated models were analysed using the finite element analysis for a 500 N bite load. The displacement of the two condylar fragments along the fracture line was calculated as an indicator of the rigidity of the fixation.Results: The displacement along the fracture was less than 0.144 mm for the neck fractures and greater than 0.165 mm for the fractures of the condylar base. A more cranial placement of the plate for the neck fractures further reduced the displacement, while a more anterior placement of the plate for the base fractures resulted in displacements greater than 0.330 mm.Conclusion: According to our study, the lambda plate offers better rigidity when applied as cranially as possible for condylar neck fractures. The lambda plate did not provide adequate fixation for base fractures. A second plate at the sigmoid notch should be considered to achieve better stabilization along the fracture if the lambda plate is eventually used.

Comparison of Preauricular Versus Retromandibular Approach in the Management of Mandibular Condyle Fractures

Objective: To compare the rate of complications encountered on using different incision to access the fracture site for the open reduction and internal fixation of condylar fractures.&#x0D; Setting: Department of Oral &amp; Maxillofacial Surgery, Institute of Dentistry, LUMHS&#x0D; Subject and Methods: A total 64 patients with unilateral condyle fractures were randomly treated into two groups. Thirty two patients in group A were treated with preauricular incision and 32 were treated with Retro mandibular incision. Patients were followed for period of upto six months for assessment of complications of facial nerve injury such as: salivary fistula and hypertrophic scar formation.&#x0D; Results: The average age of the patients was 31.66±9.40 years. Rate of facial nerve palsy was significantly high in group A than group B (18.75% vs. 6.25%; p=0.021) similarly, the rate of salivary fistula and scar formation were also significantly high in group A as compare to groups B (12.5% vs. 1.56% p=0.026) and (14.06% vs. 1.56%;p=0.013) respectively. &#x0D; Conclusion: The retromandibular approach is more suitable for the lower level condylar neck fractures, providing a direct visual field and wide, straight-line access for implant fixation at this region.