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Algorithm for Management of Mandibular Condylar Base Fractures
Erin C Peterson1, Dennis C Nguyen1, Ethan J Baughman1
1Division of Plastic and Reconstructive Surgery, Washington University in St. Louis, St. Louis, Mo.
Plastic and Reconstructive Surgery. Global Open
|November 2, 2020
Summary
This study presents a simplified algorithm for treating condylar base fractures using open reduction and internal fixation. The approach simplifies surgical management, reducing operative time and improving clinical success for these mandibular fractures.
Area of Science:
- Oral and Maxillofacial Surgery
- Trauma Surgery
Background:
- Open reduction and internal fixation (ORIf) of adult condylar base fractures show improved outcomes.
- Maxillomandibular fixation is common due to specialized training/equipment needs for ORIf.
- A simplified algorithm for condylar base fracture management is needed.
Purpose of the Study:
- To present a simplified algorithm for the surgical management of condylar base fractures.
- To streamline treatment protocols for improved patient outcomes.
Main Methods:
- Retrospective review of 22 adult patients with condylar base fractures (2016-2020).
- Two surgical techniques were employed based on fracture type: preauricular with transoral for dislocated fractures (n=2), and transoral only for non-dislocated fractures (n=20).
- Outcomes assessed included operative time, occlusion, range of motion, and complications.
Main Results:
- Condylar base fractures were often combined with other mandibular fractures (16/22 patients).
- Operative times were similar for dislocated (median 147 min) and non-dislocated (median 159 min) fractures.
- Most patients achieved preoperative occlusion without long-term complications.
Conclusions:
- A simplified algorithm for condylar base fracture treatment is proposed.
- ORIf using transoral approach alone or with a preauricular approach for dislocated fractures can reduce operative time and achieve clinical success.
