Functional Outcomes of Open Reduction and Capsular Reconstruction with Condyle-Disc Repositioning for Mandibular Condylar Head Fractures: A Case Series
摘要
Mandibular condylar head fractures are common yet challenging injuries and management remains controversial. Open reduction and internal fixation procedure enables anatomical restoration, it is technically demanding due to the cartilaginous structure of the condylar head and limited surgical access, thus can result in such complications as facial nerve injury or scarring. This case series report introduces an alternative fixation technique developed to overcome limitations of screw-based fixation that uses absorbable sutures for condylar head fracture reduction and repositioning of the articular disc.
MethodsTwo holes are drilled, one in the mandibular condyle and one in the displaced fractured fragment, and the bony segments are secured using 2 − 0 absorbable sutures. Additionally, for restoration of disc position and stability, the articular disc is secured to the lateral ligament using interrupted sutures. Details of the procedure performed for seven patients between January 2022 and December 2024, with a minimum follow-up of one year.
ResultsPostoperative assessments showed favorable functional outcomes in all cases including maximal interincisal opening exceeding 35 mm, with no mandibular deviation, TMJ pain, joint sounds, malocclusion, or facial nerve injury noted. Although radiographic anatomical restoration was largely achieved, functional recovery was consistently satisfactory in these cases.
ConclusionsRepositioning of the mandibular condyle and articular disc, both associated with the lateral pterygoid muscle, into the glenoid fossa may be essential for restoration of normal mandibular function.
Clinical Trial NumberNot applicable.