title: Open reduction and internal fixation of low subcondylar fractures of mandible through high cervical transmasseteric anteroparotid approach.
abstract: OBJECTIVE
  The aim of the present study was to evaluate the functional and radiologic results of low subcondylar fracture fixation with modus TCP plates (Medartis, Basel, Switzerland) using a high cervical transmasseteric anteroparotid approach.
  
  
  METHODS
  A prospective study was designed, enrolling all minimum-aged 15-year-old echomorphology patients presenting with displaced low subcondylar fracture with occlusion disturbances during a 41-month period. All fractures were fixed with modus TCP plates using high cervical transmasseteric anteroparotid approach. All patients underwent immediate physiotherapy and a 6-week liquid and semiliquid feeding period. Clinical and radiologic examinations were performed at 1 week and 1, 3, and 6 months. A total of 35 patients presenting with 38 fractures were enrolled with a mean follow-up of 17 months.
  
  
  RESULTS
  All fractures had healed at 6 months in the correct anatomic position in 73.7%. Occlusion was deemed normal in 80% of the patients. The mandibular movement was normal in 97.1%, with the mouth opening up to 40 mm, mean lateral movement of 11 mm without a difference between the 2 sides, and a mean protrusion of 12 mm. Minimal asymmetry remained in 15.6%. No facial palsy occurred, including no transient facial palsy. Complications consisted of 1 infection and 1 plate fracture requiring surgical revision.
  
  
  CONCLUSIONS
  Low subcondylar fracture fixation with modus TCP plates using a high cervical transmasseteric anteroparotid approach is a safe and reproducible procedure providing excellent functional results. This procedure has been routinely performed in our department.
authors.affiliation: Department of Oral and Maxillofacial Surgery and Institute of Human Anatomy (INSERM U-887), University of Burgundy Faculty of Medicine of Dijon, Dijon, France. olivier.trost@chu-dijon.fr
authors.forename: Olivier
authors.initials: O
authors.lastname: Trost
authors.forename: Pierre
authors.initials: P
authors.lastname: Trouilloud
authors.forename: Gabriel
authors.initials: G
authors.lastname: Malka
mesh_terms: D000293:Adolescent; D000328:Adult; D001860:Bone Plates; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008335:Mandibular Condyle / Q000293:injuries / Q000601:surgery*; D008337:Mandibular Fractures / Q000601:surgery*; D008406:Masseter Muscle / Q000601:surgery; D008875:Middle Aged; D019647:Oral Surgical Procedures / Q000379:methods*; D019637:Orthopedic Procedures / Q000379:methods; D010306:Parotid Gland; D011446:Prospective Studies; D016059:Range of Motion, Articular; D020127:Recovery of Function; D013704:Temporomandibular Joint / Q000293:injuries / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult