title: Combined surgical approach retromandibular and intraoral to subcondylar mandibular fractures.
abstract: BACKGROUND
  Condylar and subcondylar fractures are very common and account for at least one third of all mandibular fractures. In literature, little agreement exists about the management of extracapsular condylar and subcondylar fractures in adults. Some studies provide better results of occlusion, masticatory function, mouth opening, and bone morphology with surgical treatment. Conversely, other studies report excellent results with conservative treatment avoiding complications such as facial nerve injury and unsightly scar.
  
  
  METHODS
  In this study, we report our experience of 25 condylar/subcondylar fractures. We report the case of a man with bilateral subcondylar fractures treated by a double surgical approach, intraoral and retromamdibular. Intraoral approach lets us dissect the masseter and disconnect the temporal muscle tendon, thus favoring further reduction of fracture stumps, whereas retromandibular approach favors a good operative field and the positioning of titanium microplate.
  
  
  RESULTS
  Postoperative monitoring reported good results of occlusion. Postoperative computed tomographic scans show the good reduction and positioning of titanium miniplate.
authors.affiliation: University of Rome Tor Vergata Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Nicolai
authors.forename: Bruno
authors.initials: B
authors.lastname: Lorè
authors.forename: Leonardo
authors.initials: L
authors.lastname: De Marinis
authors.forename: Leonardo
authors.initials: L
authors.lastname: Calabrese
mesh_terms: D000328:Adult; D001860:Bone Plates; D004210:Dissection; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery; D008335:Mandibular Condyle / Q000293:injuries* / Q000601:surgery; D008337:Mandibular Fractures / Q000601:surgery* / Q000628:therapy; D008406:Masseter Muscle / Q000601:surgery; D013703:Temporal Muscle / Q000601:surgery; D013710:Tendons / Q000601:surgery; D014057:Tomography, X-Ray Computed