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Clinical Challenges
October 2004

Treatment of Adult Subcondylar Mandibular Fractures: Closed vs Open vs Endoscopic Approach

Author Affiliations




Arch Otolaryngol Head Neck Surg. 2004;130(10):1228-1230. doi:10.1001/archotol.130.10.1228

Closed reduction with rigid and/or elastic maxillomandibular fixation provides results as good as open techniques in the management of subcondylar mandibular fractures.

Subcondylar mandibular fractures differ from the fractures located more distally in the mandible for 2 main reasons. First, these fractures are in close proximity to the temporomandibular joint, which is probably the most important structure for maintaining a normal chewing function. Alterations in the anatomic relationship and subsequently the function of this portion of the mandible may significantly change occlusion and range of motion. Second, surgical exposure and placing hardware for rigid internal fixation in this region is technically not as easy as in other locations, ie, the symphyseal and parasymphyseal body and even the angle and low ramus regions. By definition, subcondylar fractures refer to fractures located below the deepest portion of the sigmoid notch and their management is probably the most controversial.

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