Modified Blair Approach for the Treatment of Mandibular Condyle Fractures

J Craniofac Surg. 2022 Oct 1;33(7):2231-2234. doi: 10.1097/SCS.0000000000008571. Epub 2022 Feb 25.

Abstract

Purpose: The management of fractures of the condyle of the mandible has been a topic of debate and still no consensus exists in the literature about the most appropriate approach. The objective of this study was to evaluate the efficacy and safety of the modified Blair approach for the open reduction and internal fixation of mandibular condyle fractures.

Methods: A retrospective study was conducted on 18 patients with 20 mandibular condyle fractures from 2014 to 2020. All patients were treated surgically using the modified Blair approach. Postoperative occlusion status and mouth opening were assessed for treatment outcomes. Also, the rate of complications such as facial nerve paralysis, wound infection, hematoma, salivary fistula, Frey syndrome, and greater auricular nerve paraeesthesia evaluated.

Results: Seventeen out of 18 patients (94.4%) achieved their original pretraumatic occlusion after the surgery. One patient (5.5%) had postoperative occlusal interference due to premature dental contact. The maximal postoperative interincisal distance was measured with a range between 33 and 41 mm (mean 37.6 mm). One patient (5.6%) had transient facial nerve palsy. Also, salivary fistula developed in 1 (5.6%) patient in the postoperative period.

Conclusion: The results of this study revealed that the modified Blair approach provides satisfactory clinical outcomes with low complication rates and may offer an alternative, safe, and effective method for open reduction and internal fixation of mandibular condyle fracture.

MeSH terms

  • Facial Paralysis* / etiology
  • Fracture Fixation, Internal / methods
  • Humans
  • Mandibular Condyle / surgery
  • Mandibular Fractures* / complications
  • Mandibular Fractures* / surgery
  • Open Fracture Reduction / adverse effects
  • Retrospective Studies
  • Treatment Outcome