The high subangulomandibular approach for condylar fractures of the mandible

• Published in: International journal of surgery case reports Vol. 85; p. 106146
• Main Authors: Kaouani, Amine, Kerdoud, Ouassime, Aloua, Rachid, Sabr, Ayoub, Slimani, Faical
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01-08-2021; Elsevier
• Subjects: Case Report; Facial trauma; Fracture of the mandibular condyle; High subangulomandibular approach; Facial trauma; Fracture of the mandibular condyle; High subangulomandibular approach
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2021.106146

The approaches to mandibular condyle fractures are described in the literature in an abbreviated manner. Their complications, especially facial nerve damage, have limited the surgical indication.
Through this clinical case, we reported the way and the interest of using a twisted steel wire to increase the visibility of the fracture site and facilitate the reduction of even the highest localized fractures.
The high subangulomandibular approach remains a safe approach, with less risk of facial nerve injury if the planes are respected and the facial nerve is avoided if encountered. Nevertheless, this approach is indicated in low condylar and some neck fractures.
Given the benefits of this approach compared to other techniques, we recommend its use.
•The high subangulomandibular approach has been proven to be superior to other approaches for mandibular condyle fractures.•The majority of surgeons practice this route only for low condylar fractures and using 3D plates.•With the help of traction of the ramus by a twisted steel wire, this route can be used for all subcondylar fractures, even the most difficult and highest.