RESUMO
OBJECTIVE: The classic technique for open reduction of subcondylar fracture is the submandibular approach. The aim of this study was to evaluate long-term clinical and radiologic results of the short retromandibular approach to displaced subcondylar fractures. MATERIAL AND METHODS: During a period of 66 months we performed a prospective study with a modified version of the retromandibular approach in 38 patients with displaced subcondylar fractures. In this article we describe clinical and radiologic results in 19 patients with follow-ups longer than 6 months (range, 6 to 66 months). Preoperatively all patients had malocclusion and radiology demonstrated displacement. RESULTS: The retromandibular surgical approach was successful in all cases. Roughly 25 months after surgery, mouth opening was 43 mm with symmetric laterotrusive movements. Permanent marginal nerve palsy was never observed. CONCLUSIONS: Our findings indicate that the short retromandibular approach is an easy and safe technique for displaced subcondylar fractures.
Assuntos
Côndilo Mandibular/lesões , Fraturas Mandibulares/cirurgia , Osteotomia/métodos , Placas Ósseas , Seguimentos , Fixação Interna de Fraturas , Humanos , Fraturas Mandibulares/diagnóstico por imagem , Estudos Prospectivos , RadiografiaRESUMO
A variety of interposition materials have been used to prevent recurrence after arthroplasty in treatment of temporomandibular joint ankylosis. The purpose of this retrospective study of our experience was to compare the different materials (skin, temporal muscle, homologous cartilage) used for interposition arthroplasty over a period of 22 years. A total of 25 patients (32 joints) with at least 3 years of follow-up were included. Good results were achieved in 92% of cases using total full thickness skin graft and 83% of cases using temporal muscle flap. Homologous cartilage gave poor results.
Assuntos
Anquilose/cirurgia , Artroplastia/métodos , Transtornos da Articulação Temporomandibular/cirurgia , Adolescente , Adulto , Cartilagem/transplante , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Prótese Articular , Estudos Longitudinais , Masculino , Côndilo Mandibular/cirurgia , Pessoa de Meia-Idade , Amplitude de Movimento Articular , Recidiva , Estudos Retrospectivos , Transplante de Pele , Retalhos Cirúrgicos , Músculo Temporal/transplante , Transplante HomólogoRESUMO
Various approaches have been proposed for surgical treatment of displaced condylar fractures included submandibular approach, preauricular approach, rhytidectomy approach or intraoral approach. Since 1992, we used a short retromandibular approach to treat displaced subcondylar fractures with a miniplate. When open reduction and osteosynthesis are required, the retro-mandibular approach is an easy and safe technique for displaced condylar fractures. The aim of this article was to describe the short retro-mandibular approach. Indications for surgical treatment, surgical approach and techniques of osteosynthesis for condylar fractures are discussed.