Retromandibular reduction of medially dislocated condylar process fractures

Area of Science:

• Oral and Maxillofacial Surgery
• Trauma Surgery
• Anatomy

Background:

• Condylar process fractures constitute one-third of mandibular fractures.
• Medial dislocation of the distal fragment is common due to lateral pterygoid muscle pull.
• Retromandibular approaches offer limited visualization in medially dislocated fractures.

Purpose of the Study:

• To summarize cases of retromandibular reduction for medially dislocated condylar process fractures.
• To describe a supplementary procedure for realigning severely dislocated condylar processes.
• To evaluate the efficacy of retromandibular reduction with or without transoral assistance.

Main Methods:

• Nine patients with medially dislocated condylar process fractures were surgically treated.
• A conventional retromandibular approach was used in six cases.
• A supplementary transoral procedure was employed for three cases with severe dislocation to the middle cranial fossa.
• Evaluated parameters included angle difference, ramus height, and maximal mouth opening (MMO).

Main Results:

• All nine cases achieved anatomical alignment without major complications.
• Statistically significant improvements were observed in angle difference and ramus height post-surgery.
• Maximal mouth opening significantly increased from 11.44 mm preoperatively to 37.2 mm postoperatively.

Conclusions:

• Retromandibular reduction is a viable treatment for medially dislocated condylar process fractures.
• Transoral assistance is beneficial for realigning severely dislocated condylar processes into the middle cranial fossa.
• The combined approach leads to successful union and functional recovery.