Reduction Of Mandibular Fractures Research Articles

Bioabsorbable plates versus metal miniplate systems for use in endoscope-assisted open reduction and internal fixation of mandibular subcondylar fractures

PurposeTo compare bioabsorbable plates with metal miniplate systems for use in endoscope-assisted open reduction and internal fixation (EAORIF) of mandibular subcondylar fractures. Materials and methodsThis retrospective cohort study included patients with mandibular subcondylar fractures treated with EAORIF using bioabsorbable unsintered hydroxyapatite/poly l-lactide composite plates or titanium miniplate systems. The outcome variables included preoperative fracture conditions, postoperative stability during fracture healing, and complications during the follow-up period. Other variables included clinical characteristics (age, sex, fracture site, and total follow-up duration) and intra- and postoperative data (surgical duration, duration of intermaxillary fixation/elastic band guidance). Variables were evaluated using descriptive statistics and compared between groups using the Mann–Whitney test and the chi-square test or Fisher's exact test, as appropriate. ResultsIn total, 28 patients were analyzed, including 13 who underwent EAORIF using bioabsorbable plates and 15 who underwent EAORIF using titanium miniplates. With the exception of second surgery for plate removal, none of the assessed variables showed significant differences between the two groups (p < 0.05). ConclusionsOur results suggest that EAORIF using biodegradable plates is a stable and reliable method for the management of mandibular subcondylar fractures and eliminates the need for secondary surgery for plate removal.

Outcomes of functional treatment versus open reduction and internal fixation of condylar mandibular fracture with articular impact: A retrospective study of 83 adults.

The treatment of fractures in the mandibular condylar process remains controversial. The aim of this study was to assess the outcomes of isolated functional treatment versus open reduction and internal fixation (ORIF) of mandibular condylar fracture with articular impact based on clinical and radiological criteria. Eighty-three patients with a mandibular condylar fracture with articular impact were included in this retrospective study. They were divided according to Loukota, Spiessl and Schroll, Mercier and Rasse, Neff, and Hlawitschka classifications. Two groups were created: operated patients (operated) and non-operated patients (non-operated). Occlusal and functional features were evaluated using clinical measurements at 1, 3, 6, and 12 months after the treatment as well as radiological measurements performed preoperatively, 6 weeks later, and at the end of the follow-up. A male predominance was observed in the data (69.9%, P<0.0001). Isolated functional treatment was applied in 55 patients (66.26%). Twenty-eight patients (33.7%) were operated upon using a pre-auricular or modified Risdon's approach. Maximal mouth opening (MMO) was lesser in "operated" group compared to "non-operated" group until 6 months (25.75mm vs 31.96mm, 34.76mm vs 37.95mm, 38.06mm vs 41.87mm respectively 1, 3 and, 6 months, P<0.05). Results were satisfactory 1 year after treatment (41.29mm vs 45.22mm, P>0.05). There was no difference concerning temporo-mandibular joint dysfunctions between operated and non-operated patients. For unilateral fractures, the loss of height of the ramus was significantly higher in operated patients initially compared to "non-operated" group (P=0.0137). After surgical correction, there was no difference between the two sides of mandible. At the end of the follow-up, the there was no difference between operated and non-operated ramus (P=0.1304 and 0.6420). The present study showed that a properly followed isolated functional treatment provided similar clinical results to ORIF for mandibular condylar fractures with articular impact. Surgical treatment should be preferred when the loss of height of the ramus is severe to restore the ramus height since adult condylar remodeling is less efficient than in children.

A Comparative Assessment of Postoperative Analgesic Efficacy of Lornoxicam versus Tramadol after Open Reduction and Internal Fixation of Mandibular Fractures.

Pain after any surgical procedure is inevitable but can be controlled by administration of analgesics in most cases. Postoperative pain after surgical treatment of mandibular fractures can be treated by nonsteroidal anti-inflammatory drugs (NSAIDs) and opioid analgesics. The purpose of this study is to critically compare the postoperative analgesic efficacy of small doses of intravenous TRAMADOL (opioid analgesic) versus LORNOXICAM (NSAID) in patients with mandibular trauma undergoing open reduction and internal fixation (ORIF) and to assess the presence of any adverse effects due to NSAID or opioid use. Forty adult ASA grade I-II patients with mandibular trauma, scheduled for ORIF under general anesthesia in the Department of Oral and Maxillofacial Surgery, College of Dental Sciences, Davangere, were selected for the study. The patients were randomly assigned into a tramadol group (Group T) and a lornoxicam group (Group L) and were administered intravenous tramadol 50 mg and intravenous lornoxicam 8 mg, respectively, at specific postoperative intervals. Pain intensity was quantitatively assessed at the 2nd, 4th, 6th, 12th, and 24th postoperative hours using a visual analog scale of 10 cm. Adverse effects of the analgesics were also recorded and compared. Both the drugs resulted in a significant decrease in pain intensity from 2nd to 24th postoperative hours, but better pain control was observed in Group L at 24th postoperative hour. Only two patients experienced nausea and vomiting in Group T and one patient experienced gastric acidity in Group L. The comparative results clearly demonstrate that pain control by intravenous lornoxicam is significantly better than by intravenous tramadol at 24th postoperative hour after ORIF of mandibular trauma. Side effects produced by both the drugs were minor and had no apparent effect on the study results.

A Technique for Reduction of Edentulous Fractures Using Dentures and SMARTLock Hybrid Fixation System.

Summary:Establishing anatomic reduction of an edentulous mandible fracture is a frequently acknowledged challenge in craniomaxillofacial trauma surgery. In this study, we report a novel method for the reduction of the edentulous mandible fracture, via fabrication of modified Gunning splints using existing dentures and SMARTLock hybrid arch bars. This technique dramatically simplifies the application of an arch bar to dentures, obviates the need for the fabrication of impressions and custom splints, and eliminates the lag time associated with the creation of splints. Furthermore, this method may be used with or without adjunctive rigid internal fixation. The technique described herein of creating Gunning splints with SMARTLock hybrid arch bars provides surgeons with a simple, rapid, single-stage solution for reduction of mandibular fractures in the edentulous patient.

Should patients take vitamin D before mandibular operations?

Vitamin D deficiency is endemic in the United Kingdom (UK), particularly in high-risk groups. We report the outcomes of patients with low concentrations of the vitamin who had complications after reduction of mandibular fractures or osteotomy, and those who were screened preoperatively. A deficiency can be diagnosed with a simple and inexpensive blood test, and in the UK the cost of a vitamin D tablet is about £0.04/tablet/day. Patients at risk of a deficiency should be screened before mandibular operations, and those listed for orthognathic surgery or replacement of the temporomandibular joint should be asked to take a supplement before operation.

Non-IMF mandibular fracture reduction techniques: A review of the literature

BackgroundIntermaxillary fixation (IMF) techniques are commonly used in mandibular fracture treatment to reduce bone fragments and re-establish normal occlusion. However, non-IMF reduction techniques such as repositioning forceps may be preferable due to their quick yet adequate reduction. The purpose of this paper is to assess which non-IMF reduction techniques and reduction forceps are available for fracture reduction in the mandible. MethodsA systematic search was performed in the databases of Pubmed and EMBASE. The search was updated until February 2016 and no initial date and language preference was set. Results14 articles were selected for this review, among them ten articles related to reduction forceps and four articles describing other techniques. Thus, modification and design of reduction forceps and other reduction techniques are qualitatively described. ConclusionFew designs of repositioning forceps have been proposed in the literature. Quick and adequate reduction of fractures seems possible with non-IMF techniques resulting in anatomic repositioning and shorter operation time, especially in cases with good interfragmentary stability. Further development and clinical testing of reduction forceps is necessary to establish their future role in maxillofacial fracture treatment.

Newer condylar trapezoidal plate in treatment of mandibular condyle fractures : short clinical study

Mandibular condyle fracture is one of the most frequent injuries of the facial skeleton. The treatment ofmandibular condyle is either closed reduction or open reduction with internal fixation. The open reduction of mandibular condyle fractures has become more favorable and gaining popularity since various osteosynthesis materials and techniques were developed in the past few decades. These include fixation with Kirschner wires, intraosseous wiring, miniplates, and lag screw fixation. In response to a increased number of needs for improved treatment in this region, a variable morphological plates have been developed with specific designs to treat such fractures. We present a case series of use of new condylar trapezoidal plate (condylar fragment plate) in the treatment of mandibular condyle fractures.

Are Biodegradable Plates Applicable in Endoscope-Assisted Open Reduction and Internal Fixation of Mandibular Subcondyle Fractures?

To investigate whether biodegradable plates are applicable in endoscope-assisted open reduction and internal fixation (EAORIF) of mandibular subcondyle fractures. This retrospective case-series study included patients with mandibular subcondyle fractures treated with EAORIF using an unsintered hydroxyapatite particles/poly-l-lactide biodegradable plate system, with at least 6months of clinical follow-up data available. The outcome variables were fracture healing with postoperative stability and postoperative complications. Other variables included age, gender, fracture site, cause of injury, accompanying mandibular fracture, total follow-up period, fracture classification, extent of displacement, preoperative status of occlusion, preoperative mandibular movements, fixation materials in accompanying mandibular fracture, location and number of fixation plates, periods of intermaxillary fixation/elastic bands, and postoperative mandibular movements. Fracture healing in these patients was assessed by comparing the immediate postoperative cone-beam computed tomography (CBCT) images with those obtained at least 3months after surgery. A total of 11 patients, 9 male and 2 female, with a mean±standard deviation age of 35.3±15.9years, were included. The mean follow-up period was 18.8±7.8months. Four patients had an accompanying mandibular fracture. Two 4-hole, 2.0-mm biodegradable plates were fixed with 6-mm screws along the posterior border of the mandibular ramus and near the sigmoid notch. Complete bone formation around the fracture lines or fading of the fracture lines, with no change in the position of the fractured segments, was observed on the postoperative CBCT images at 3months. With the exception of 2 patients, no patient complained of plate palpability, deviation in occlusion, or discomfort during the postoperative follow-up period. EAORIF using biodegradable plates for mandible subcondylar fractures is a stable and reliable method, with considerable advantages compared with titanium plates.

Comparison of Pain Relief from Different Intravenous Doses of Ketorolac after Reduction of Mandibular Fractures.

Pain is an unpleasant feeling due to tissue destruction, which disturbs an individual's daily routines even at its lowest levels. The majority of surgeons and anaesthesiologists are increasingly trying to administer non-opioid analgesics because excessive use of opioids after surgery results in patient dissatisfaction. To evaluate the analgesic effect of intravenous injection of different doses of ketorolac at different intervals in patients undergoing surgery for unilateral fractures of the mandible. In the present randomized clinical trial (March 2016 to January 2017, in Tabriz Imam Reza Treatment/Educational Center), 50 patients were assigned to five groups with simple randomization method. In Group 1 and 2, immediately before the induction of general anaesthesia 30 and 60 mg of ketorolac and in Group 3 and 4, immediately before termination of surgery 30 and 60 mg of ketorolac was injected intravenously. In Group 5, ketorolac was not administered. After each patient regained complete consciousness, the severity of pain was determined using VAS up to 24 hours at baseline and at 2, 4, 6, 12 and 24-hours intervals. The total dose of the opioid analgesic agent (morphine-pethidine) and the time for the first request for an analgesic agent were recorded for each patient and their means were compared in each group with suitable statistical tests. The patients in Group 5 and 4 exhibited the highest and lowest mean pain scores (5.03±0.9 and 3.5±1), respectively. ANOVA for repeated measures and post-hoc Tukey tests showed significant differences only between Group 3 and 5 (p=0.002) and Group 4 and 5 (p=0.001), with no significant differences between the other groups (p>0.005). The highest dose of the analgesic agent was in Group 5 (5.3±1.4 mg) and the lowest dose was recorded in Group 4 (1.6±0.6 mg). Patients in the control group received significantly higher doses compared to the other groups (p<0.05). The patients in Group 1 and 2 received higher doses of analgesics compared to Group 3 and 4 (p<0.05). The longest time for the request for the first dose of analgesic agent after surgery was 73.4±12.03 minutes in Group 4 The patients in the control group had requested analgesics after surgery at a significantly shorter time compared to the patients in all the study groups (p<0.05). The patients in Group 1 and 2 had requested analgesics at a shorter time after surgery compared to the subjects in Group 3 and 4 (p<0.05). Intravenous administration of 30 and 60 mg of ketorolac, immediately before termination of surgery, decreases the pain severity and the need for opioid analgesics after surgery.

Otorhinolaryngology/Head and Neck Surgery in a low income country: The Haitian experience

ObjectiveLittle is known regarding the diagnosis and management of pediatric surgical conditions of the head and neck in low-income countries. Haiti, the western hemisphere's poorest country, recently developed its first Otorhinolaryngology (ORL) department at the Hopital de L'Universite d’Etat d’Haiti (HUEH). This manuscript assesses the caseload at HUEH with a special emphasis on pediatric cases, with the aim of characterizing ORL related conditions and their treatments in low-income countries. MethodsWe conducted a retrospective chart review of surgical case logs at HUEH for the calendar year of 2014 and recorded patient age, diagnosis, and surgical intervention for all ORL surgeries. ResultsA total of 229 ORL surgeries were performed at HUEH during this time. The average age of the patient was 21.8 years and 54.2% of patients were 18 years or younger. The five most common diagnoses were tonsillar hypertrophy (23.6%), ingested foreign body (18%), mandibular fracture (9.2%), unspecified head or neck mass (6%), and thyroid goiter (4.8%). The five most common surgeries performed were tonsillectomy (23.6%), foreign body retrieval (17.9%), open reduction of mandibular fracture with direct skeletal fixation (6.9%), thyroidectomy (7.9%), and excision of unspecified mass. Trauma accounted for 33.6% of all ORL surgeries. ConclusionsDiseases related to the head and neck constitute a common yet underserved surgical problem. Strengthening ORL surgical capacity in Haiti should focus on improving capacity for the most common conditions including tonsillar disease, ingested foreign bodies, and facial trauma, as well as improving capacity for rarely performed surgeries, such as ear surgery, nose and sinus surgery, and cancer resections.

Outcomes of Manual Reduction vs Arch Bars for Mandibular Angle Fractures

Objective: To compare post-operative complications of mandibular angle fractures treated with manual reduction, arch bar maxillomandibular fixation (MMF), and non-arch bar MMF.

A novel computer algorithm for modeling and treating mandibular fractures: A pilot study.

To describe a novel computer algorithm that can model mandibular fracture repair. To evaluate the algorithm as a tool to model mandibular fracture reduction and hardware selection. Retrospective pilot study combined with cross-sectional survey. A computer algorithm utilizing Aquarius Net (TeraRecon, Inc, Foster City, CA) and Adobe Photoshop CS6 (Adobe Systems, Inc, San Jose, CA) was developed to model mandibular fracture repair. Ten different fracture patterns were selected from nine patients who had already undergone mandibular fracture repair. The preoperative computed tomography (CT) images were processed with the computer algorithm to create virtual images that matched the actual postoperative three-dimensional CT images. A survey comparing the true postoperative image with the virtual postoperative images was created and administered to otolaryngology resident and attending physicians. They were asked to rate on a scale from 0 to 10 (0 = completely different; 10 = identical) the similarity between the two images in terms of the fracture reduction and fixation hardware. Ten mandible fracture cases were analyzed and processed. There were 15 survey respondents. The mean score for overall similarity between the images was 8.41 ± 0.91; the mean score for similarity of fracture reduction was 8.61 ± 0.98; and the mean score for hardware appearance was 8.27 ± 0.97. There were no significant differences between attending and resident responses. There were no significant differences based on fracture location. This computer algorithm can accurately model mandibular fracture repair. Images created by the algorithm are highly similar to true postoperative images. The algorithm can potentially assist a surgeon planning mandibular fracture repair. 4. Laryngoscope, 2016 127:331-336, 2017.

Extramedullary fixation combined with intramedullary fixation in the surgical reduction of sagittal mandibular condylar fractures

This study aimed to evaluate the clinical effect of extramedullary fixation combined with intramedullary fixation during the surgical reduction of sagittal mandibular condylar fractures. Twenty-four sagittal fractures of the mandibular condyle in18 patients were fixed by two appliances: intramedullary with one long-screw osteosynthesis or Kirschner wire and extramedullary with one micro-plate. The radiologically-recorded post-operative stability-associated com-plications included the screw/micro-plate loosening, micro-plate twisting, micro-plate fractures, and fragment rotation. The occluding relations, the maximalinter-incisal distances upon mouth opening, and the mandibular deflection upon mouth opening were evaluated based on follow-up clinical examination. Postoperative panoramic X-ray and CT scans showed good repositioning of the fragment, with no redislocation or rotation, no screw/plate loosening, and no plate-twisting or fracture. Clinical examination showed that all patients regained normal mandibular movements, ideal occlusion, and normal maximal inter-incisal distances upon mouth opening. Extramedullary fixation combined with intramedullary fixation is highly recommended for sagittal condylar fractures because of the anti-rotation effect of the fragment and the reasonable place-ment of the fixation appliances.

Which Factors Are Associated with Open Reduction of Adult Mandibular Condylar Injuries?

The purpose of this study was to identify factors associated with the decision to perform open reduction and internal fixation of mandibular condylar fractures. This was a retrospective cohort study of patients with mandibular condylar fractures managed by the plastic and reconstructive surgery, oral and maxillofacial surgery, and otorhinolaryngology services over a 15-year period. Bivariate associations and a multiple logistic regression model were computed for injury characteristics that were associated with open reduction and internal fixation. For all analyses, a value of p ≤ 0.05 was considered significant. Six hundred fifty-four condylar injuries were identified in 547 patients. The sample's mean age was 36.0 ± 16.5 years, 20.5 percent were women, and 63 percent were Caucasian. The most common mechanisms of injury were motor vehicle collisions (49 percent), 53.4 percent involved the subcondylar region and 20 percent were bilateral injuries. Associated noncondylar mandibular fractures were present in 60 percent of cases; 20.7 percent were managed with open reduction and internal fixation. The overall complication rate was 21.6 percent. In a multiple logistic regression model, factors associated with an increased likelihood of open reduction and internal fixation were the presence of extracondylar mandibular injuries, condylar neck or subcondylar region injuries, increasing dislocation, and treatment by plastic and reconstructive surgery/oral and maxillofacial surgery (p ≤ 0.04). Increasing severity of mandibular injury, lower level of fracture, joint dislocation, and treatment by plastic and reconstructive surgery/oral and maxillofacial surgery are associated with open reduction and internal fixation of mandibular condylar injuries. Risk, III.

Effect of Preoperative Oral Amantadine on Acute and Chronic Postoperative Pain After Mandibular Fracture Surgery.

BackgroundPostoperative pain from open reduction and internal fixation of mandibular fracture is a serious issue. Amantadine is an N-methyl-D-aspartic acid or N-methyl-D-aspartate (NMDA) receptor antagonist that can be effective against postoperative pain.ObjectivesThe present study examined the efficacy of amantadine in alleviating the postoperative pain of mandibular fracture surgery.Patients and MethodsIn this double-blind study, 60 patients (ASA physical status I–II) were randomly divided into two groups. The mean ages of the participants were 31.2 ± 13.1 years and 32.3 ± 18.1 years, respectively. The male/female ratios were 24/6 and 26/4, respectively, in the case and control groups. Randomization was based on a single sequence of random assignments using computer-generated random numbers. Group I was given oral amantadine 100 mg 1 hour before surgery, and group II received a placebo at the identical time. Through PCA pumps, patients received a bolus dose of morphine at 0.02 mg/kg body weight, to a maximum of 1.5 mg. PCA pumps were set at 6 minutes lockout intervals and a maximum dose of 0.15 mg/kg/h, to a maximum of 10 mg/h. Pain was assessed using a visual analog scale (VAS) at 0, 2, 4, 6, 12, and 24 hours and 1, 2, 3, 4, 5, and 6 months after surgery. The amounts of analgesic consumed were recorded for the first 24 hours, and for 6 months after surgery.ResultsThere were no significant differences between the two groups with respect to age, gender, nausea and vomiting, sleep quality, blood pressure, and heart rate. No significant differences were observed between the two groups in pain scores (P = 0.39) and analgesic consumption (P = 0.78).ConclusionsThe results suggest that a single dose of preoperative oral amantadine did not reduce acute or chronic postoperative pain, nor analgesic consumption.

Retrospective study of experience of craniofacial reconstruction.

Reconstruction is a basic task in craniofacial plastic surgery. Different methods must be used to meet the aspirations of surgeons and patients with different defects and deformities. We make a retrospective study of our experience of craniofacial reconstruction. In accordance with 10 years' clinical experience, direct suturing, skin graft transfer, nerve anastomosis, expanded pedicled or random flaps, facial local random flaps, reduction of mandibular fracture and correction of congenital craniofacial deformities were included in this case series. These types of treatment were applied to reconstruct facial defects or deformities according to different circumstances of patients. Directed by rational design and treatment, reconstructive surgery can be executed to treat different cases with different circumstances. A total of 891 different cases with different facial circumstances were treated with different methods: direct suturing (n = 93), skin graft transfer(n = 104), nerve anastomosis (n = 38), expanded pedicled or random flaps(n = 310), facial local random or pedicled flaps(n = 231), reduction of mandibular fracture(n = 112) and correction of congenital craniofacial deformities(n = 13). Reconstructive technique must be directed by reliable methods and special guidelines in Plastic Surgery. Three guidelines are summarised: reconstruction in the first stage and returning injured tissue to its origin site as far as possible for traumatic events; adjacent tissue must be prior to other distant tissue for reconstructive choice; and reconstruction at different stages after careful design.

Postoperative radiographs after open reduction and internal fixation of mandibular fractures: clinical need or unnecessary radiation?

Postoperative radiographs are conventionally taken after open reduction and internal fixation (ORIF) of mandibular fractures, but routine radiographic exposure in patients who have no clinical signs may not be justified. To find out whether radiographs influence immediate postoperative management, and whether they can be used to predict long-term complications, we retrospectively reviewed the radiographs and case notes of 92 patients who had ORIF of isolated mandibular fractures between June 2010 and June 2012. We evaluated them for the adequacy of reduction and fixation using locally agreed criteria, and correlated them with immediate and long-term outcomes as recorded in the case notes. Eleven patients had complications, usually infection. All 4 patients who required repeat ORIF had worrying signs and symptoms despite the immediate postoperative radiograph looking favourable. The radiographs of 7 patients looked unfavourable, but no patient required another operation, and none developed complications. Routine postoperative radiographs after ORIF of mandibular fractures seem to have little value in the management of patients, as the decision to reoperate is based on clinical signs rather than radiographic appearance, and radiographic appearance is not associated with long-term outcomes. Our findings suggest that radiographs are valuable only in patients with clear clinical indications and, in view of the risk and cost of radiation, we question their continued use.

Impact of Body Mass Index on the Outcomes of Open Reduction for Mandibular Fractures

Little is known about the impact of body mass index (BMI) on the postoperative outcomes of open reduction for mandibular fractures. The aim of this study was to investigate the relationship between BMI and short-term outcomes of surgery for mandibular fractures. We searched the Japanese Diagnosis Procedure Combination database to identify patients who underwent open reduction for mandibular fractures from July 2010 to March 2013. BMI was divided into three groups: less than 18.5kg/m(2) (underweight), 18.5 to 24.9kg/m(2) (normal weight), and 25kg/m(2) or greater (overweight). The outcomes included postoperative complication rates, duration of anesthesia, length of stay, and total costs. We analyzed the relationships between BMI and the outcomes by multivariable regression analyses. We analyzed 309 patients who underwent open reduction for mandibular fractures during the study period. The group with a BMI of 25kg/m(2) or greater had a significantly longer hospital stay (3.8days; 95% confidence interval, 0.5 to 7.1days, P = .03) than the group with a normal BMI. BMI was not significantly associated with duration of anesthesia, postoperative complication rates, or total costs. Regarding open reduction for mandibular fractures, overweight status may be associated with a prolonged length of stay, but may have little impact on operating time, postoperative morbidity, or overall costs.

下顎骨関節突起骨折の観血的整復固定術におけるhigh perimandibular approarchの有用性

下顎骨関節突起骨折の観血的整復固定術におけるhigh perimandibular approarchの有用性

Modified endaural approach for the treatment of condylar fractures: A review of 75 cases.

There are several treatment approaches for mandibular condyle fractures. Type of fracture, clinical experience, and preference of the operating surgeon dictate the approach. Given this highly varied outcome, this manuscript intends to document the treatment experience of 75 patients with extracapsular condyle fractures using author's modification of the traditional endaural approach in the region. A retrospective chart review was performed on patients with mandibular condylar fractures who visited the author's center between 2004 and 2014. For the surgical reduction and fixation, an endaural (ear) approach via the author's modification of Al-Kayat Bramley's incision in the superficial temporal region was used. Postoperative clinical parameters were evaluated which include the degree of mouth opening, chin deviation during mouth opening, occlusal relationship, temporomandibular joint function, radiographic stability, and other postoperative complications of condylar fractures such as infection, plate fracture, and permanent paralysis of facial nerve. Adolescence/adult patients with unilateral/bilateral condylar fracture who underwent open reduction with the follow-up of at least 1 year were included in the study. Edentulous and patients <15 years who underwent closed treatment were excluded from the study. The study group consisted of 75 cases of mandibular condyle fractures, of which 55 cases were of unilateral condyle fractures and 20 cases were of bilateral condylar fractures. Postoperative follow-up of patients ranged from 1 to 10 years with the mean of 3.04 ± 1.93 years. The occlusal relationships were excellent in all with the mean degree of mouth opening of 40.11 mm (maximum 4.5 cm and minimum 2.9 cm), of which four patients reported restricted mouth opening. Orthopantomogram and computed tomography showed complete anatomical reduction of the condyle fracture in all patients. Nine out of 75 patients developed transient facial weakness, with no other postoperative complications of condylar fractures such as infections, plate fracture, and permanent paralysis of facial nerve were noted. The overall success rate was 92%. Surgery for mandibular condyle fractures with modified approach allows direct vision of the fracture and reduces surgical trauma to the site while avoiding permanent facial nerve injury. Hence, the author's modified Al-Kayat Bramley incision via endaural approach could be considered as the best approach for open reduction and internal fixation of condylar neck and subcondylar mandibular fractures.