OBJECTIVE :
Fractures of the mandibular condyle represents 20–52% and angle fractures accounts for 23–42% of all mandibular fractures. They have limited intra-oral access and hence the management becomes difficult. The ideal management of mandibular fracture should have an objective of perfect anatomical reduction and complete stable fixation.
Majority of surgeons prefer the extra-oral approach than intra-oral approach, because it gives a good visualization and an ability to achieve a better alignment of the fracture site. However, open reduction by an extra-oral approach results rarely in some complications like facial nerve injury salivary fistula formation and in few patients hypertrophic scar and keloid formation.
The intra-oral approach minimizes the risk of visible scars and facial nerve injury. But this technique cannot be used in patients with high sub-condylar fractures, displaced angle of mandible fractures, trismus with oral sub-mucous fibrosis, due to lack of accessibility to place screws and plates according to paralleling technique of reduction and fixation. The use of angled drills, screw drivers and trocars to place the screws has eliminated the need for an extra-oral incision.
Trans-buccal fixation of sub-condylar and angle of mandible fractures can be carried out using trocar instrumentation. The technique offers advantages like, accessibility during placement of the bone plates and screws according to the paralleling technique for the reduction and fixation. Also, less potential for surgical morbidity with insignificant cutaneous surgical scar.
Disadvantages are difficulty in exposing the posteriorly positioned fractures as retraction and lighting are limited. It is a sensitive technique. The surgeon has to be familiar with the armamentarium, also should be skilled in the use of trocar cannula. The purpose of the present study was to evaluate the management of sub-condylar and angle of mandible fracture by a trans-buccal trocar along with an intra-oral approach.
WHAT WILL YOU LEARN IN THIS SESSION ?
DATE : SUNDAY, FEBRUARY 20, 2022
TIME : 5 P.M. IST | 8.30 P.M. Korean Time
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