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RESEARCH PRODUCT

Open Reduction and Internal Fixation of Low Subcondylar Fractures of Mandible Through High Cervical Transmasseteric Anteroparotid Approach

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Purpose The aim of the present study was to evaluate the functional and radiologic results of low subcondylar fracture fixation with modus TCP plates (Medartis, Basel, Switzerland) using a high cervical transmasseteric anteroparotid approach. Materials and Methods A prospective study was designed, enrolling all minimum-aged 15-year-old echomorphology patients presenting with displaced low subcondylar fracture with occlusion disturbances during a 41-month period. All fractures were fixed with modus TCP plates using high cervical transmasseteric anteroparotid approach. All patients underwent immediate physiotherapy and a 6-week liquid and semiliquid feeding period. Clinical and radiologic examinations were performed at 1 week and 1, 3, and 6 months. A total of 35 patients presenting with 38 fractures were enrolled with a mean follow-up of 17 months. Results All fractures had healed at 6 months in the correct anatomic position in 73.7%. Occlusion was deemed normal in 80% of the patients. The mandibular movement was normal in 97.1%, with the mouth opening up to 40 mm, mean lateral movement of 11 mm without a difference between the 2 sides, and a mean protrusion of 12 mm. Minimal asymmetry remained in 15.6%. No facial palsy occurred, including no transient facial palsy. Complications consisted of 1 infection and 1 plate fracture requiring surgical revision. Conclusions Low subcondylar fracture fixation with modus TCP plates using a high cervical transmasseteric anteroparotid approach is a safe and reproducible procedure providing excellent functional results. This procedure has been routinely performed in our department.