Retromandibular Transparotid Approach Versus Transmasseteric Anteroparotid Approach for Fixation of Subcondylar Fracture

Retromandibular Transparotid Approach Versus Transmasseteric Anteroparotid Approach for Fixation of Subcondylar Fracture: Randomized Controlled Clinical Study

Background: Condylar fracture is one of mandibular fracture which accounts for 20-35%. It is the most controversial fractures regarding diagnosis and management. For several years, surgeons preferred closed reduction over open reduction to avoid surgical complications.

Closed reduction may have late complications, the preference started to change towards open treatment. A Transmasseteric Anteroparotid (TMAP) approach for open treatment of condylar fractures overcomes the problems of facial nerve injury of other approaches. Aim: Comparing the Transmasseteric Antroparotid approach(TMAP) to the Transparotid (TP) approach in management of subcondylar fractures regarding the facial nerve affection, parotid fistula, reduction angulation, pain, duration of the surgery, occlusion and patient satisfaction with the scar. Materials and Methods: Twenty patients with subcondylar fracture will be divided randomly into two equal groups. Group1(study group): Transmasseteric Antroparotid approach. Group2 (control group): Retromandibular Transparotid approach. Patients will be followed up for 3 months to assess facial nerve injury, pain, occlusion and patient's scar satisfaction . Results: data will be collected, tabulated and statistically analysed.

Study Overview

• Status: Completed
• Conditions: Condylar Fractures
• Intervention / Treatment: Procedure: transmasseteric anteroparotid approach; Procedure: transparotid approach

• Study Type: Interventional
• Enrollment (Actual): 20
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Alexandria, Egypt
    • Alexandria University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Patients suffering from displaced extracapsular mandibular subcondylar fracture indicated for open reduction including:

Difficulty of obtaining adequate occlusion by closed method. Radiological signs of the following:

1. Deviation of the he fragments from the axis of the ascending ramus in medial or lateral direction more than 10°. (28)
2. Shortening of the ascending ramus ≥ 2 mm measured from the roof of glenoid fossa to the inferior border of the ascending ramus of the mandible.
3. Dislocation of the condyle from the glenoid fossa.

Exclusion Criteria:

• Patients who were not able to follow the information given or to make a decision themselves due to mental or other problems. 2. Patient with undisplaced condylar fractures that doesn't cause malocclusion or loss of facial heightening and can be treated conservatively.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: transmasseteric anteroparotid approach	Procedure: transmasseteric anteroparotid approach; safer approach for condylar fracture
Active Comparator: transparotid approach	Procedure: transparotid approach; facial nerve and parotid dissection to reach condyle

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
facial nerve injury	immediate postoperative

Secondary Outcome Measures

Outcome Measure	Time Frame
approach time	interaoperative

Collaborators and Investigators

• Sponsor: Alexandria University

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2024
• Primary Completion (Actual): December 30, 2025
• Study Completion (Actual): December 30, 2025

Study Registration Dates

• First Submitted: February 5, 2026
• First Submitted That Met QC Criteria: February 5, 2026
• First Posted (Actual): February 11, 2026

Study Record Updates

• Last Update Posted (Actual): February 12, 2026
• Last Update Submitted That Met QC Criteria: February 10, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: 0841-01/2024

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No