外科ジャーナル

Comparative Study of Different Approaches for Subcondylar Fracture Repair

Abstract

Yaser M. El Sheikh, Mohammed Fakher Mohammed Abdou Seleeman* and Hossam H. Fawzy

Background: The mandible is a typical site for face fractures. Extraoral rather than intraoral treatments are typically recommended for treating subcondylar fractures among the various surgical techniques because they may be given an adequate surgical vision. The majority of physicians concurred that fractures of the mandibular condylar neck or subcondyle, either displaced bilaterally or unilaterally are the right surgical indications for ORIF.

Aim of the work: To compare between intraoral, transparotid and retromandibular approaches in management of submandibular fracture.

Patients and methods: This study included 20 patients complaining of subcondylar fracture of mandible in plastic Menoufia University's medical faculty has a department of surgery. Three groups of patients were assigned to them based on surgical approach: Group A included seven patients undergoing surgical fixation via the intraoral approach. Group B included seven patients undergoing surgical fixation via the transparotid approach. Group C included six patients undergoing surgical fixation via the retromandibular approach.

Results: Between groups, a statistically significant difference was discovered. Regarding operating and time. Intraoral approach had a signifcanlty longer operating time compared to transparotid and retromandibular approaches. Between groups, a statistically significant difference was discovered regrading field of surgical exposure retromandibular and trasnpartid have wide field of exposur. Surgical site infection was reported in two (28.6%), one (14.3%), Facial weakness was reported in four (57.1%) patients in group A and One (14.3%) patient in group B. Two (28.6%) and One (14.3%) patient in groups A and B respectively suffered from a salivary fistula. Implant loosening was reported in one (14.3%) patient in group A, and one (16.7%) patient in group C. Trismus was reported in one (14.3%) patient in group B, and one (16.7%) patient in group C.s SIX patient in group A (78.1%) and four patient (57.1%) in group B complaining of visible scar . No occlusal stability was reported in either group and one No cases of postoperative bleeding were reported.

Conclusion: Transparotid and retromandibular were better approaches in management of submandibular fracture.