Comparison of approaches for the rigid fixation of sub-condylar fractures

The objective of this study was to compare the rate of complications encountered on using different incisions to access the fracture site for the open reduction and internal fixation of isolated subcondylar fractures. The parameters evaluated are: the occurrence of salivary fistula, infection, and injuries to the seventh facial nerve. An assessment of the surgical scar was also undertaken.

20 patients who met the previous criteria and were willing to participate in the study were placed (five each) into the pre-auricular, submandibular, retromandibular transparotid or retromandibular transmassetric group based on the incision scar they selected after a description of the operation and being explained about the possible complications.

Comparison of the complications could not ascertain the superiority of any approach over the other since the outcomes were not statistically significant. However, judging by operator and assistants' subjective assessment, the retromandibular approaches seem to provide a more direct visual field and an almost straight line access for the fixation of the fracture. The transmassetric approach seems to be a safer approach since the nerves encountered can be visualized and avoided.