Artroscopia de la articulación temporomandibular en fracturas condilares

Abstract

Damage to the intra-articular soft tissues of the temporomandibular joint (TMJ) during a condylar fracture has traditionally been neglected and poorly studied. Arthroscopy is a minimally invasive surgical procedure that can be combined with the open approach for condylar fractures, in order to diagnose intra-articular damage and treat it if necessary. After conducting a literature review, only 4 articles have been published on arthroscopic findings and they reveal a pathology greater than expected which, if not resolved, can lead to significant long-term sequelae. A clinical case of a displaced right subcondylar fracture is presented in which an arthroscopy of the TMJ is combined with an open approach and reduction of the fracture in the same act. The most common arthroscopic findings are hemarthrosis, clots, disc displacement, hyperplastic synovitis, fibrocartilage damage, and disc perforations. The present review concludes that it is necessary to evaluate and diagnose intra-articular damage in mandibular condylar fractures and that arthroscopy is an adequate method that also allows treating associated joint pathology.