Retromandibular and trans-parotid trans-masseteric surgical approaches to extracapsular mandibular condylar neck and subcondylar fractures: a retrospective descriptive case series

Abstract

Background: Extracapsular fractures of the mandibular condylar neck and subcondylar region are frequent maxillofacial injuries. Their management remains debated because closed treatment avoids extraoral surgical morbidity, whereas open reduction and internal fixation may improve anatomical reduction and occlusal stability in selected displaced fractures.

Methods: This retrospective descriptive case series included surgically treated extracapsular mandibular condylar process fractures managed at a single maxillofacial unit. Eligible fractures were condylar neck or subcondylar fractures treated with retromandibular, trans-parotid trans-masseteric, or combined surgical access. Preoperative assessment included clinical examination, cone-beam computed tomography or computed tomography, and three-dimensional reconstruction. Postoperative assessment included clinical monitoring and postoperative imaging. Only descriptive statistics were used; no comparative or inferential analysis was performed.

Results: This series comprised 73 mandibular condylar process fractures, including 25 condylar neck fractures and 48 subcondylar fractures. The mean age was reported as 35 years. A retromandibular approach was used for condylar neck fractures. Reported adverse events included 3 temporary lower facial nerve branch weaknesses, 2 rhomboid plate fractures approximately 1 month after surgery, and 1 screw fixation failure after 40 days. No persistent facial expression deficit or occlusal sequelae were reported in the available text.

Conclusions: This retrospective descriptive case series documents the authors' operative experience with retromandibular and related approaches to extracapsular condylar fractures.