Treatment of Diacapitular Condylar Fractures

Study Overview
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Brief Summary
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A new surgical approach, denoted as the supratemporalis approach, was designed to treat diacapitular condylar fractures of the mandibular condyle.This approach prevented facial nerve injury and did not increase the frequency of other complications. Therefore, the investigators suggest this surgical procedure as a routine and safe approach to diacapitular condylar fractures, which can also be applied to temporomandibular joint（TMJ）and to the zygomatic arch.

Detailed Description
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Eighty-four patients (112 sides) with diacapitular condylar fractures were treated surgically. Forty-four patients (64 sides) were treated with the supratemporalis approach, and forty patients (48 sides) were treated with traditional preauricular approach. Data on the surgical procedures and complications were recorded. The follow-up periods were 12 -24months. The evaluated parameters include facial nerve injury，the maximum mouth opening, mandibular movements, occlusion, scar formation，hemorrhage and infection.Seven patients sustained facial nerve paresis in the group treated with the traditional preauricular approach. No case of facial nerve injury was observed in the supratemporalis approach group. No other significant differences were detected between the two groups in the functional and esthetic aspects.

Official Title
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A Modified Preauricular Approach to Treat Diacapitular Condylar Fractures: The Supratemporalis Approach

Conditions
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Mandibular Fractures

Intervention / Treatment
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* Procedure: The supratemporalis approach


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: clinical and radiographical diagnosis of DFs; Exclusion Criteria: condylar fractures with undisplaced fractures; Fractures without the reduction of the condylar height; A obvious scar at the temporal region, affecting the placement of the original incision.

Ages Eligible for Study
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Minimum Age: 4 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| the preauricular approach<br>A classic preauricular incision was used to treat diacapitular condylar fractures | Procedure: The supratemporalis approach<br>* The supratemporalis approach was applied in treatment of diacapitular condylar fractures<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from facial nerve function at 24 hours postoperatively | The patients were instructed to raise their eyebrows, wrinkle the forehead, gently close the eyes, blow the cheek and smile. Paralysis of the facial nerve was deemed to have occurred if these motions were not achieved. | 24 hours | 
| Change from facial nerve function at 1 week postoperatively | The patients were instructed to raise their eyebrows, wrinkle the forehead, gently close the eyes, blow the cheek and smile. Paralysis of the facial nerve was deemed to have occurred if these motions were not achieved. | 1 week | 
| Change from facial nerve function at 3 months postoperatively | The patients were instructed to raise their eyebrows, wrinkle the forehead, gently close the eyes, blow the cheek and smile. Paralysis of the facial nerve was deemed to have occurred if these motions were not achieved. | 3 months | 
| Change from facial nerve function at 6 months postoperatively | The patients were instructed to raise their eyebrows, wrinkle the forehead, gently close the eyes, blow the cheek and smile. Paralysis of the facial nerve was deemed to have occurred if these motions were not achieved. | 6 months | 
| Change from facial nerve function at 12 months postoperatively | The patients were instructed to raise their eyebrows, wrinkle the forehead, gently close the eyes, blow the cheek and smile. Paralysis of the facial nerve was deemed to have occurred if these motions were not achieved. | 12 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Facial Nerve Injuries