Management of refractured mandibular condyle after open reduction and internal fixation

Area of Science:

• Oral and Maxillofacial Surgery
• Trauma Surgery
• Orthognathic Surgery

Background:

• Mandibular fractures, particularly in the condylar region, present complex surgical challenges.
• Refracture after initial open reduction and internal fixation (ORIF) is uncommon but requires careful management.
• Previous ORIF may compromise bone stock, complicating subsequent reconstructive procedures.

Purpose of the Study:

• To highlight the surgical management of a refractured mandibular condylar segment.
• To present a case of successful treatment of mandibular refracture using a matrix mandible plate.
• To evaluate the efficacy of matrix plates in complex condylar reconstructions.

Main Methods:

• A patient with a refractured mandible underwent surgical intervention.
• Initial fixation involved miniplates for the condyle and a reconstruction plate for the parasymphysis.
• Refracture management utilized an 11-hole reconstruction plate for the symphysis and a 4-hole matrix mandible plate for the subcondylar fracture.

Main Results:

• The patient achieved good mouth opening and pre-injury occlusion post-operatively.
• A full range of functional mandibular movements was restored.
• The matrix mandible plate provided stable fixation for the refractured condylar segment.

Conclusions:

• Refracture of the mandible, especially the condyle, necessitates tailored surgical approaches.
• Matrix mandible plates offer a promising and effective solution for managing complex mandibular refractures.
• This approach can restore pre-injury function in challenging cases.