Is extracorporeal fixation in mandibular condylar fractures a viable option? a systematic review.

BACKGROUND

Mandibular condyle fractures (MCFs) are common injuries, often resulting from trauma and leading to functional complications. Treatment approaches remain debated, with extracorporeal fixation emerging as a potential alternative to conventional methods. This study explores the effectiveness and outcomes of this technique to guide clinical decision-making.

MATERIALS AND

METHODS

A comprehensive search was conducted across PubMed, EMBASE, and BVS (VHL) for studies published until August 2024. The review included observational studies and clinical trials that assessed postoperative complications following extracorporeal fixation in MCFs.

RESULTS

Thirty-one studies, comprising 436 participants, were included. Data were extracted on trauma etiology, fracture classification, surgical approaches, and complications such as condylar resorption, which was the most common (18.58%). The studies varied in surgical techniques, with submandibular (40.62%) and retromandibular (37.5%) accesses being the most common. Osteosynthesis materials such as miniplates, screws, and wires were frequently used. Follow-up durations ranged from immediate post-operative periods to 15 years. The quality assessment revealed fair to moderate study quality, with observational studies generally showing methodological limitations, such as sample size issues and heterogeneity in surgical technique and follow-up. Despite concerns about condylar resorption and temporomandibular joint dysfunction, most studies reported that these complications did not significantly affect function or occlusion.

CONCLUSIONS

Extracorporeal fixation of MCFs offers a promising alternative in cases with limited condylar access where conventional methods may fail. Despite a higher risk of condylar resorption, studies suggest minimal long-term functional impairment. This technique remains viable for complex fractures. However, robust clinical trials are needed to evaluate long-term outcomes, particularly regarding resorption and postoperative recovery, given their potential to affect mandibular function, occlusion, and temporomandibular joint health.