Abordaje retromandibular transparotídeo con fijación rígida en fracturas subcondíleas

Introduccion: el manejo terapeutico de las fracturas subcondileas ha sido controversial, demostrando su reduccion abierta y fijacion rigida excelentes resultados, por lo que se realizo este estudio del abordaje retromandibular transparotideo con fijacion rigida en fracturas subcondileas. Objetivo: caracterizar demograficamente la muestra estudiada; describir los resultados clinicos y radiograficos obtenidos e identificar accidentes y complicaciones. Material y metodos: se ejecuto un estudio de casos en 25 pacientes del total de pacientes con fracturas subcondileas que acudieron al servicio de Cirugia Maxilofacial del Hospital Universitario "Miguel Enriquez", 2002-2011. Se realizo abordaje retromandibular transparotideo y fijacion rigida; se analizaron variables demograficas, variables clinicas y radiograficas, accidentes y complicaciones. Se evaluaron cronologicamente. Resultados: predominaron pacientes con edades entre 15-24 anos (40%) y el sexo masculino (80%); las fracturas unilaterales (80%) y las subcondileas altas (40%). A los 7 dias, la maxima apertura bucal promedio 39 mm y 3 mm de deflexion. Se registro 100% de reduccion anatomica y oclusion estable. Conclusiones: el abordaje retromandibular transparotideo con fijacion rigida es un metodo adecuado de tratamiento de las fracturas subcondileas con excelentes resultados esteticos y funcionales. Introduction: controversy exists regarding the management of mandibular condyle fractures, but the open approach with rigid fixation has been successful. A study was done about Retromandibular transparotideal approach with rigid fixation in subcondylar fractures. Objective: to characterize demographically the studied sample, to describe the obtained clinical and radiographical results, to identify associated accidents and complications. Material and methods: a case series study was carried out in 25 patients of the total of patients with subcondylar fractures diagnosis who attended to the Maxillofacial Departament, University Hospital "Miguel Enriquez", between 2002-2011. The sample was subjected to surgical treatment by means of retromandibular approach and rigid fixation. The studied variables were: demographical, clinical and radiographical variables; accidents and complications. The patients were evaluated chronologically. Results: patients among 15-24 years (40%), masculine sex (80%), unilateral fractures (80%), and high subcondylar (40%) prevailed. In 7 days the average value of maximum buccal opening was 39 mm and 3 mm of deflexion. 100% of the cases registered anatomical reduction. Conclusions: the transparotideal retromandibular approach with rigid fixation is an appropriate method of treatment of sub-condylar fractures with excellent aesthetic and functional results.