The Management of Sub-Condylar and Angle of Mandible Fracture by a Trans-Buccal Trocar Along With an Intra-Oral Approach

Abstract

This chapter aims to evaluate the management of sub-condylar and angle of mandible fracture by a trans-buccal trocar along with an intra-oral approach. The intra-oral approach minimizes the risk of visible scars and facial nerve injury.  Assessment of the appropriateness of anatomical repositioning, fixation, and stability of the fracture site by radiographs, as well as pre- and post-operative occlusion by photographs, were study parameters. After six months, an orthopantomogram was used to assess the fracture gap and evaluate the anatomical repositioning using the paired student's T test. During the pre-operative period for a mandibular angle fracture, the mean anatomical repositioning fracture gap measurement on an orthopantomogram was 4.06 mm with a standard deviation of 1.42 mm, and six months later, the mean was 0.5 mm with a standard deviation of 0.32 mm.  The P value was 0.00001, which shows a very high significant. Pre-operatively, the mean of the anatomical repositioning fracture gap measurement on the orthopantomogram for sub-condylar fractures was 6.77 mm with a standard deviation of 3.54 mm, and six months later, it was 1.57 mm with a standard deviation of 2.37 mm. The P value could not be determined because of the tiny sample size. When placing a plate and screws, the trans-buccal trocar technique offers acceptable anatomical repositioning, fixation, stability, occlusion, and good accessibility.