A comparative evaluation of retromandibular versus Modified Risdon approach in surgical treatment of condylar fracture |
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| Affiliation: | 1. Associate Professor of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tanta University, Egypt;2. Associate Professor of Oral and Maxillofacial Surgery, Faculty of Dentistry, Taibah University, KSA, Saudi Arabia;1. Dept. Maxillofacial Surgery, Head and Neck Cancer Centre, University and University Hospital of Lübeck, Lübeck, Germany;2. Dept. of Pathology, University and University Hospital of Lübeck, Lübeck, Germany;1. Institute of Radiology, Friedrich-Alexander-University Erlangen-Nuremberg, Maximiliansplatz 3, 91054, Erlangen, Germany;2. Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, Glueckstrasse 11, 91054, Erlangen, Germany;1. The Peoples'' Friendship University of Russia, 6 Miklukho-Maklaya St., Moscow, 117198, Russian Federation;2. I.M. Sechenov First Moscow State Medical University (Sechenov University), 8/2 Trubetskaya St., 119991, Moscow, Russian Federation;3. Burdenko Main Military Clinical Hospital, 3 Gospitalnaya Poloschad, Moscow, 105229, Russian Federation;1. Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, LMU Munich, Germany;2. Center of Oral, Maxillofacial and Facial Reconstructive Surgery, Ansbach, Germany;3. Department of Oral and Maxillofacial Surgery, Martin-Luther University Halle, Germany;4. Department of Pathology, University Hospital, LMU Munich, Germany;1. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, PR China;2. The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, PR China |
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| Abstract: | The purpose of this study was aimed to compare the efficiency and safety of retromandibular versus modified Risdon approach using periangular incision for open reduction and internal fixation of low subcondylar mandibular fracture. Open reduction and internal fixation with different plating systems were utilized via retromandibular approach (group I) and via modified Risdon approach with periangular incision (group II).Twenty four (n= 24) condylar fractures in 21 adult patients were divided randomly into two equal groups (12 each) according to the cutaneous incision (approach) utilized. The evaluation score for scarring in group I it was excellent in 9 patients, good in 2 patients and acceptable in only one patient (Mean 2.4 ± SD 3.38). While in group II was excellent in 10 patients and good in 2 patients (Mean 2.4 ± SD 3.87) and the p value was 0.591. Symptoms of transient facial nerve weakness were noted in only 3 patients in group I with slight to moderate dysfunction (Mean 2 ± SD 3.21), while only one patient had facial nerve weakness in group II with House - Brackman score of 2 immediate postoperatively and this got resolved in 6 weeks (Mean 2 ± SD 4.04) and the p value was 0.00022.Within the limitations of the study it seems that a modified Risdon approach using periangular incision for reduction and fixation of low subcondylar fracture should be preferred whenever possible because it yields better outcomes. |
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| Keywords: | Condylar fracture Retromandibular Periangular |
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