Management of Sub-Condylar and Angle of Mandible Fracture by a Trans-Buccal Trocar Along With an Intra-Oral Approach
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Management of Sub-Condylar and Angle of Mandible Fracture by a Trans-Buccal Trocar Along With an Intra-Oral Approach Deepti Krishnan Kutty1 • Neelakamal Hallur1 • Aaisha Siddiqa1 • Syed Zakaullah1 • Chaitanya Kothari1
Received: 7 July 2020 / Accepted: 12 August 2020 Association of Otolaryngologists of India 2020
Abstract To evaluate the management of sub-condylar and angle of mandible fracture by a trans-buccal trocar along with an intra-oral approach. Study parameters included were assessment of adequacy of anatomical repositioning, fixation and stability of fracture site by radiographs, pre and post – operative occlusion by photographs. Evaluation of anatomical repositioning was done with fracture gap measurement on orthopantomogram after 6 months by applying paired student’s T test. In mandibular angle fracture, pre- operatively, the mean of anatomical repositioning fracture gap measurement on orthopantomogram was 4.06 mm with a standard deviation of 1.42 mm and 6 months post-operatively, the mean was 0.5 mm with a standard deviation of 0.32 mm. The P value was \ 0.00001, which shows a very high significant. In sub-condylar fractures, pre- operatively, the mean of anatomical repositioning fracture gap measurement on orthopantomogram was 6.77 mm with a standard deviation of 3.54 mm and 6 months post-operatively, the mean was 1.57 mm with a standard deviation of 2.37 mm. As the sample size was small, P value could not be calculated. The & Deepti Krishnan Kutty [email protected] Neelakamal Hallur [email protected] Aaisha Siddiqa [email protected] Syed Zakaullah [email protected] Chaitanya Kothari [email protected] 1
Department Of OMFS, Al Badar Rural Dental College & Hospital, Kalaburagi, India
use of the trans-buccal trocar provides adequate anatomical repositioning, fixation, stability, occlusion and good accessibility during placement of plate and screws. Keywords Sub-condylar fracture Angle of mandible fracture Trans-buccal trocar Intra-oral approach
Introduction 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 [1]. The ideal management of mandibular fracture should have an objective of perfect anatomical reduction and complete stable fixation [2]. 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 [3]. However, open reduction by an extra-oral approach results rarely in some complications like facial nerve injury [3, 4] salivary fistula formation [4] and in few patients hypertrophic scar and keloid formation [3]. 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
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