# Postoperative Complications Following Open Reduction and Internal Fixation of Mandibular Condylar Fractures Using the High Perimandibular Approach: A Multicenter Retrospective Study

## TL;DR

This study evaluates the high perimandibular approach for fixing jaw fractures and finds it effective but notes a common complication of limited mouth opening.

## Contribution

The study provides new clinical evidence on the safety and complications of the high perimandibular approach for mandibular condylar fractures.

## Key findings

- Post-operative trismus occurred in 38.1% of patients at 6 months.
- Longer surgical duration and dislocated fractures were significantly associated with trismus.
- The high perimandibular approach was found to be safe and effective for managing these fractures.

## Abstract

Background: The high perimandibular approach (HPA) is a feasible surgical technique for open reduction and internal fixation (OR-IF) of mandibular condylar fractures, offering reduced complication rates. In this study, we retrospectively evaluated the treatment outcomes and complications associated with HPA use. Patients and Methods: Patients who underwent OR-IF for mandibular condylar fractures using the HPA at three hospitals in Shimane between June 2019 and March 2024 were included. Data collected included the mechanism of injury, AO classification of the fracture site, fracture type and mode, surgical duration, mouth-opening range at 6 months post-operatively, and peri- and post-operative complications. Results: A total of 42 patients (46 condylar fractures; 18 males and 24 females; mean age, 63.0 years) were included. The fracture pattern included dislocations in 18 cases (42.8%). The mean surgical duration was 75.0 min. Post-operative trismus occurred in 16 patients (38.1%) at 6 months. Longer surgical duration and dislocated fractures were significantly associated with post-operative trismus (p < 0.05). Conclusions: The HPA is safe and effective for managing mandibular condylar fractures. However, post-operative trismus may be influenced by longer surgical duration and fracture types, warranting further investigation and potential post-surgical management.