Open Reduction of Subcondylar Fractures Using a New Retractor

Abstract

Many operative approaches have been described for the open reduction of subcondylar fractures and rigid fixation. However, fracture portions are deep and embedded among facial nerves so that visual surgery in this region is extremely limited. Once the operative field is exposed, the displacement of the condylar head is often dislocated by the anteromedial pull of the lateral pterygoid muscle and the fracture end of the condylar process is pulled up to the mandibular fossa by contraction of the masseter muscle. We made a new retractor to achieve a better field of view. It is possible to pull down the condylar process by opening the tips of the retractor using the specially made wrench system without special effort and keep the condylar process in the same position during reduction. In using this retractor, the fracture stumps were clearly exposed and more easily reposited.