Zygomatic arch osteotomy for open reduction and internal fixation of medially displaced/dislocated condylar head in high condylar fractures

Elavenil Panneerselvam, Saravanan Chellappazham, Sasikala Balasubramanian, VB Krishnakumar Raja

Annals of Maxillofacial Surgery 2018 8(2):311-314

Purpose: Open reduction and internal fixation of high condylar fractures is challenging. The difficulty gets compounded when the condylar head is medially displaced or dislocated. The surgical procedure is limited by inadequate visibility and restricted access to the fractured condyle for proper reduction and fixation. When conventional methods of reduction fail, "osteotomy-osteosynthesis" is performed to retrieve and fix the fractured condylar head. However, they are extensive surgeries and associated with morbidity. Methods: This article presents a novel technique "zygomatic osteotomy (ZO)" performed on a cadaver to facilitate retrieval of the displaced head and achieve ideal reduction and fixation. A comparison of the existing techniques with the proposed ZO has been done in detail. Conclusion: The "ZO" technique is easy to perform with less potential for complications.

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