Management of refractured mandibular condyle after open reduction and internal fixation

The purpose of the present case is to highlight the surgical management of the refractured condylar segment of the mandible after open reduction and internal fixation. A man in his 20s reported to the department with an alleged history of road traffic injury (RTI). He was diagnosed with a fracture of the right parasymphysis and left subcondylar region of the mandible. He was managed surgically using 2 mini plates of 2.0 mm in relation to the condyle, one 5-hole miniplate in relation to the posterior border of the mandible, one 3-hole miniplate in relation to the anterior border of the condyle. A 2.4 mm 8-hole reconstruction plate was placed in relation to the right parasymphysis region of the mandible. He again reported to the department of oral and maxillofacial surgery after 25 days with an alleged history of RTI. After a complete examination, he was diagnosed with a fracture of the symphysis and left subcondylar region of the mandible. He was managed surgically using 11-hole reconstruction plate 2.4 mm with bicortical screws to fix symphysis fracture of the mandible. A 4-hole high-profile matrix mandible 2.0 mm plate was used to fix the left subcondylar fracture. Now the patient is having good mouth opening, preinjury occlusion and a good range of functional movements of the mandible.After functionally stable fixation of the condyle and rigid fixation of the anterior mandible, refracture is rarely reported. The anatomy of the condyle is complex, so after the removal of the miniplates, the bone available is less. The purpose of reporting the present case is to highlight the management of refracture of the condyle using matrix mandible plate. The use of a synthes matrix mandibular plate is promising in such cases and can be used effectively.