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Facial Plast Surg 2016; 32(04): 424-430
DOI: 10.1055/s-0036-1584554
Rapid Communication
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Contemporary Issues in the Open Management of Subcondylar Fractures of the Mandible

Jeffrey Cranford
1   Department of Facial Plastic Surgery, New York Eye and Ear Infirmary of Mount Sinai, New York, New York
,
Sameep Kadakia
1   Department of Facial Plastic Surgery, New York Eye and Ear Infirmary of Mount Sinai, New York, New York
,
Raja Sawhney
2   Department of Facial Plastic and Reconstructive Surgery, University of Florida Health Science Center, Gainesville, Florida
,
Yadranko Ducic
3   Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas
› Author Affiliations
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Publication History

Publication Date:
05 August 2016 (online)

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Abstract

Subcondylar fractures encompass a large portion of mandible fractures. Owing to their proximity to the temporomandibular joint and difficulty achieving surgical exposure, treatment of these fractures has been challenging and highly debated throughout the literature. While no one modality is the accepted gold standard, there are multiple options for addressing these fractures that can yield satisfying results for both patient and surgeon alike. A thorough literature review was conducted using PubMed, analyzing articles in the past 15 years for relevance to the subject matter. Various search terms were used to glean information regarding closed treatment, open treatment, and the risks and benefits of the different surgical approaches involved. The articles were reviewed by all of the authors for applicability and quality of data provided. A total of 50 articles were selected for inclusion in the current study. The open management of subcondylar fractures encompasses a vast array of techniques. While some surgeons advocate closed treatment in some circumstances, open treatment affords numerous advantages with the advent of multiple access modalities. There is no single superior method, and as such, the craniofacial surgeon should have a comprehensive understanding of options so as to select the appropriate option that is individualized to the patient. A clear understanding of fracture biomechanics balanced with patient expectations and operative safety allows for the surgeon to make a sound decision for treatment.

Keywords

trauma - condylar fracture - management
 

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