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Open reduction and internal fixation of extracapsular mandibular condyle fractures: a long-term clinical and radiological follow-up of 25 patients

Spinzia, Alessia and Patrone , Renato and Belli, Evaristo and Dell'Aversana Orabona, Giovanni and Ungari, Claudio and Filiaci, Fabio and Agrillo, Alessandro and De Riu, Giacomo and Meloni, Silvio Mario and Liberatore, Gianmauro and Piombino, Pasquale (2014) Open reduction and internal fixation of extracapsular mandibular condyle fractures: a long-term clinical and radiological follow-up of 25 patients. BMC Surgery, Vol. 14 (68), p. 10. eISSN 1471-2482. Article.

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DOI: 10.1186/1471-2482-14-68


Background: During the last 2 decades, many studies on the treatment of mandibular condyle fracture have been published. The incidence of mandibular condyle fractures is variable, ranging from 17.5% to 52% of all mandibular fractures. This retrospective study evaluated the long-term clinical and radiological outcomes after surgical treatment of 25 patients with a total of 26 extracapsular condyle fractures.
Methods: We used 2 types of surgical approaches, the retromandibular retroparotid or preauricular approach. Three kinds of rigid internal fixation plates were used—single plate, double plate, and trapezoidal plate. The following post-operative clinical parameters were evaluated: dental occlusion, facial nerve functionality, skin scarring, and temporomandibular joint functionality. All patients underwent post-operative orthopanoramic radiography and computed tomography. The patients were also monitored for complications such as Frey’s syndrome, infection, salivary fistula, plate fracture, and permanent paralysis of the facial nerve; the patient’s satisfaction was also recorded.
Results: Of the 25 patients, 80% showed occlusion recovery, 88% had no facial nerve injury, and 88% presented good surgical skin scarring. The patients showed early complete recovery of temporomandibular joint functionality and 72% of them were found to be asymptomatic. The postoperative radiographs of all patients indicated good recovery of the anatomical condylar region, and 80% of them had no postoperative complications. The average degree of patient satisfaction was 8.32 out of 10. Our results confirm that the technique of open reduction and internal fixation in association with postoperative functional rehabilitation therapy should be considered for treating patients with extracapsular condylar fractures.
Conclusion: The topic of condylar injury has generated more discussion and controversy than any other topic in the field of maxillofacial trauma. We confirm that open reduction and internal fixation is the treatment of choice for patients with neck and sub-condylar mandibular fractures.

Item Type:Article
ID Code:10177
Uncontrolled Keywords:Extracapsular mandibular condyle fractures, open reduction and rigid internal fixation, clinical and radiological follow-up, mandibular fracture
Subjects:Area 06 - Scienze mediche > MED/29 Chirurgia maxillofacciale
Divisions:001 Università di Sassari > 01-a Nuovi Dipartimenti dal 2012 > Scienze Chirurgiche, Microchirurgiche e Mediche
Publisher:BioMed Central
Copyright Holders:© 2014 Spinzia et al.; licensee BioMed Central Ltd.
Deposited On:13 Oct 2014 15:39

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