Surgical Management of Mandibular Subcondylar Fractures Under Local Anesthesia: A Proposed Protocol.

摘要: Purpose The optimal treatment for adult mandibular condylar fractures (MCFs) has largely shifted in favor of open reduction and rigid internal fixation. However, a sizeable portion these injuries are still being treated closed manner based on old literature, convenience, results deemed acceptable, lesser associated morbidity. Most MCFs with multiple facial traumas appropriately under general anesthesia (GA). some selected isolated or those minimal low midfacial can be optimally patients local following protocol presented this article, thus expediting simplifying their management. purpose study was to develop safe, sound, effective routine surgical management subcondylar anesthesia. Patients Methods We carried out prospective clinical assess the feasibility operating Seven other underwent surgery after careful case selection our proposed protocol. outcome variables were 1) duration procedure, 2) intraoperative pain assessed by visual analog scale, 3) fracture measuring preoperative postoperative average gap, 4) presence malocclusion preoperatively postoperatively, 5) deviation mouth opening, 6) maximal opening. Results mean procedure 35.14 minutes, rating discomfort 0.57 as reported scale patients. Mean opening improved from 17.1 40.5 mm, whereas 4.4 0.28 mm. gap reduced 6.32 0.97 mm. Conclusions is straightforward, efficient, cost-effective tool MCFs, avoiding GA its attendant risks complications, that used routinely, well whom unsuitable.