Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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Outcome of Open Reduction Via Retromandibular Approach for Mandibular Subcondyle Fracture

하악골 과두경부 골절에 있어서 후하악부 절개법을 이용한 관혈적 정복술의 유용성

  • Lee, Hyung Chul (Department of Plastic & Reconstructive Surgery, Dankook University of Medicine) ;
  • Kang, Dong Hee (Department of Plastic & Reconstructive Surgery, Dankook University of Medicine) ;
  • Koo, Sang Hwan (Department of Plastic & Reconstructive Surgery, Korea University of Medicine) ;
  • Park, Seung Ha (Department of Plastic & Reconstructive Surgery, Korea University of Medicine)
  • 이형철 (단국대학교 의과대학 성형외과학교실) ;
  • 강동희 (단국대학교 의과대학 성형외과학교실) ;
  • 구상환 (고려대학교 의과대학 성형외과학교실) ;
  • 박승하 (고려대학교 의과대학 성형외과학교실)
  • Received : 2005.06.17
  • Published : 2005.11.10
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Abstract

Subcondylar fractures have generally been treated by intermaxillary fixation except in cases where there is an absolute indication for open reduction. The reason behind a less aggressive surgical approach lies on the inherent difficulties in manipulating fragments in such a small area at the risk of damaging facial nerves or vessels such as the internal maxillary artery. However, long-term follow-up studies showed that conservative treatment of subcondylar fractures results in disturbances of occlusal function, deviation of the mandible, internal derangement of the temporomandibular joint, and ankylosis of the joint. We carried out open reduction of dislocated subcondylar fractures in 14 patients from 2000 to 2004 by a retromandibular approach. After the reduction of fractured bone, two H-shaped miniplates with 6 holes were fixed with screws at the anterior and posterior surfaces of the subcondyle. The retromandibular approach allowed good access and easy manipulation of the subcondyle. Immediate relief from malocclusion and correction of mandibular midline shifting were observed in all patients. Late temporomandibular dysfunction and ankylosis were not observed. Open reduction with plate osteosynthesis made it possible to avoid IMF in 7 of the 14 patients. The present study shows that open reduction through this retromandibular approach can produce good outcome in adult patients with subcondylar fracture.

Keywords

References

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