RE-TREATMENT OF MISMANAGED BILATERAL CONDYLAR FRACTURE AND POST-SURGICAL COMPLICATION
DOI:
https://doi.org/10.46862/interdental.v19i2.7688Keywords:
Bilateral condylectomy, neglected condylar fracture, post-surgical neurological complicationAbstract
Introduction: Improper management of condyle fractures can lead to changes in the structure of the temporomandibular joint, which can impact the patient's oral function. Corrective surgery is necessary to restore the patient's function and quality of life. This case report aims to discuss the procedure of bilateral condylectomy in neglected condylar fracture, as well as the risks and post-operative complication management.
Case: A 26-year-old female patient presented with mandibular hypomobility and occasional temporomandibular pain. The patient had history of a traffic accident around four months ago, and was managed in a public hospital but symptoms persisted.
Case Treatment: After thorough examinations, the patient was diagnosed with neglected complete bilateral condylar fracture with displacement and managed via bilateral condylectomy. Post-operative, the patient presented with anterior open-bite and facial paralysis on the right side, and was treated accordingly. During 4-month follow-up, complications and chief complaints had all subsided.
Discussions: Mismanagement of condylar fracture could result in malunion of fragments, which is difficult to reposition due to the changes that have already occurred in the temporomandibular structure. Condylectomy is often necessary to relieve symptoms, although bilateral condylectomy poses certain neurological risks. Prompt recognition and intervention of nerve injury is important to prevent permanent complication.
Conclusion and Suggestions: Condylectomy could properly treat neglected bilateral condylar fracture in adult patients. Operators must know the associated risk and management of post-operative complications.
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References
Morris C, Bebeau NP, Brockhoff H, Tandon R, Tiwana P. Mandibular fractures: an analysis of the epidemiology and patterns of injury in 4,143 fractures. J Oral Maxillofac Surg. 2015;73(5):1–12.
Kozakiewicz M, Walczyk A. Current Frequency of Mandibular Condylar Process Fractures. J Clin Med. 2023;12(4):1394.
Valiati R, Ibrahim D, Abreu MER, Heitz C, De Oliveira RB, Pagnoncelli RM, et al. The treatment of condylar fractures: To open or not to open? A critical review of this controversy. Int J Med Sci. 2008;5(6):313–8.
Alyahya A, Bin Ahmed A, Nusair Y, Ababtain R, Alhussain A, Alshafei A. Mandibular condylar fracture: a systematic review of systematic reviews and a proposed algorithm for management. Br J Oral Maxillofac Surg. 2020;58(6):625–31.
Nilesh K, Vande A V. Post-traumatic deformity of mandibular condyle: Descriptive review and proposal of treatment algorithm. J Stomatol. 2020;73(1):36–43.
Punga R, Gaur S. Let Bilateral Condylar Fracture Fixation Be the Norm and Not a Choice. Cureus. 2022;14(5):1–13.
Oktora S, Sjamsudin E, Riawan L. Management of Bilateral Head-Condyle Fractures and Chronic Dislocation In Children: Case Report. Int J Med Rev Case Reports. 2020;4(0):1.
Rakhman D, Putri FA, Fathurachman F, Syamsudin E. Management of bilateral condyle fracture and mandibular corpus with the closed reduction in adolescent patients. J Kedokt Gigi Univ Padjadjaran. 2022;33(3):54.
Garoma G, Dejene D, Uma G. Temporomandibular joint ankylosis; aetiology, pattern and treatment. J Dent Heal Oral Disord Ther. 2022;13(2):33–7.
Kumaran A, Soh HL. Management of Nonunion and Malunion After Primary Mandibular Condylar Fracture Treatment: A Review and Recommendations. J Oral Maxillofac Surg. 2020;78(12):2267–72.
Hoffman D, Puig L. Complications of TMJ Surgery. Oral Maxillofac Surg Clin North Am. 2015;27(1):109–24.
Al-Moraissi EA, Ellis E. Surgical treatment of adult mandibular condylar fractures provides better outcomes than closed treatment: A systematic review and meta-analysis. J Oral Maxillofac Surg. 2015;73(3):482–93.
García-Guerrero I, Ramírez JM, Gómez de Diego R, Martínez-González JM, Poblador MS, Lancho JL. Complications in the treatment of mandibular condylar fractures: Surgical versus conservative treatment. Ann Anat. 2018;216:60–8.
Alpert B, Jones LC. Complications of Mandibular Fractures. In: Facial Trauma Surgery. Elsevier; 2020. p. 201–22.
Boffano P, Holmes S, Brucoli M. The Management of Posttraumatic Facial Skeletal Deformity Affecting the Occlusion: The Early Malunited Mandible. Atlas Oper Maxillofac Trauma Surg Post-Traumatic Deform. 2020;747–51.
Hillam J, Isom B. Mandible Dislocation. StatPearls [Internet]. Florida: StatPearls Publishing; 2023. 4–6 p.
Bordoni B, Varacallo M. Anatomy, head and neck, temporomandibular joint. StatPearls [Internet]. Florida: StatPearls Publishing; 2022. 4–7 p.
Naik K, Lee KC, Torroni A. Does open reduction and internal fixation provide a quality-of-life benefit over traditional closed reduction of mandibular condyle fractures? J Oral Maxillofac Surg. 2020;78(11):2018–26.
Prakash Sr R, Ramesh K, Alwala AM, Porika R, Katkuri S, Prakash R, et al. Open reduction and internal fixation versus closed reduction and maxillomandibular fixation of condylar fractures of the mandible: a prospective study. Cureus. 2022;14(1).
Madadian MA, Simon S, Messiha A. Changing trends in the management of condylar fractures. Br J Oral Maxillofac Surg. 2020;58(9):1145–50.
Kamel GN, De Ruiter BJ, Baghdasarian D, Mostafa E, Levin A, Davidson EH. Establishing a protocol for closed treatment of mandibular condyle fractures with dynamic elastic therapy. Plast Reconstr Surg Glob Open. 2019;7(12).
Pius A. Management Options for Bilateral Condylar Fracture: A Review. J Adv Med Dent Sci Res. 2020;8(9).
Leonard JR, Mancoll W, Duncan DG. Condylectomy: Role in Treatment of Jaw Fractures. Arch Otolaryngol. 1968;87(4):425–33.
Malik NA. Textbook of oral and maxillofacial surgery. New Delhi; Philadelphia: Jaypee; 2016.
Vesnaver A, Ahčan U, Rozman J. Evaluation of surgical treatment in mandibular condyle fractures. J Cranio-Maxillofacial Surg. 2012;40(8):647–53.
Doh R-M, Shin S, You TM. Delayed paresthesia of inferior alveolar nerve after dental surgery: case report and related pathophysiology. J Dent Anesth pain Med. 2018;18(3):177–82.
Cole T, Nicks R, Ferris S, Paul E, O’Brien L, Pritchard E. Outcomes after occupational therapy intervention for traumatic brachial plexus injury: a prospective longitudinal cohort study. J hand Ther. 2020;33(4):528–39.
Nedeljković P, Dacić S, Kovačević M, Peković S, Vučević D, Božić-Nedeljković B. Vitamin B complex as a potential therapeutical modality in combating peripheral nerve injury. Acta Medica Median. 2018;57(2):85–91.
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