Open Reduction Internal Fixation of Condylar Head/Diacapitular Fracture of Mandible: Case Series

Application of Crus of Helix Incision Through the Posterior Parotid Gland Approach in the Mid-Level or High-Level Mandibular Condylar Fractures

OBJECTIVE

This study is to explore the clinical effect of crus of helix incision through the posterior parotid gland approach in the treatment of Mid-or High-Level mandibular condylar fractures.

METHODS

From September 2020 to June 2023, we performed incision reduction internal fixation of 23 patients with mid-level or high-level fractures of the mandibular condylar through the approach of the posterior parotid gland, and observed the effect of the operation.

RESULTS

After a follow-up period of 6 to 12 months, all patients showed no signs of postoperative facial paralysis or salivary gland fistula. In addition, satisfactory scars were observed in the operation area, and the occlusion function had recovered well.

CONCLUSION

The approach of using a crus of helix incision through the posterior parotid gland proved to be an effective method for treating mid-level or high-level fractures of the condylar fractures. This technique offers several advantages, including adequate exposure, minimal facial nerve injury, ease of incision and reduction, inconspicuous scarring, and a more concealed incision.

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

Background

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.

Purpose

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.

Methods and Materials

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.

Results

The treatment outcomes are better achieved with ease to surgeon and with minimal armamentarium without any special needs per se.

Conclusion

The technique proposed is novel and can help achieve desired outcomes even in hands of budding surgeon with minimal time and efforts invested.