Evaluation of the retromandibular transparotid approach for open reduction and internal fixation of mandibular condylar and subcondylar fractures: A clinical observational study

Background: Mandibular condylar fractures constitute nearly one-third of all mandibular fractures and, if inadequately treated, may result in significant functional and anatomical sequelae. While closed reduction has traditionally been preferred, open reduction and internal fixation (ORIF) through the retromandibular transparotid approach (RMA) provides direct visualization, stable fixation, and anatomical accuracy. Aims and Objectives: This study aimed to evaluate the effectiveness, safety, and post-operative outcomes of the RMA in the management of condylar and subcondylar fractures. Materials and Methods: A prospective clinical observational study was conducted in the Department of Oral and Maxillofacial Surgery, Bharatpur Hospital. Twelve patients with condylar neck or subcondylar fractures underwent ORIF through the RMA. Clinical and radiographic data were analyzed for operative access, duration, mouth opening, occlusion, facial nerve function, scarring, and complications. Results: The patients (10 males and two females; mean age was 36.3 years, range 21–56 years) showed excellent functional recovery. The mean post-operative interincisal opening improved to 28.6±4.8 mm (P=0.001). All patients achieved satisfactory occlusion intraoperatively; one patient developed a minor occlusal discrepancy, which was corrected with selective intermaxillary fixation. No cases of transient or permanent facial nerve weakness, wound dehiscence, infection, salivary fistula, or sialocele were observed. Scars were esthetically acceptable, with no patients reporting visible marks during follow-up. Conclusion: The RMA provides excellent access and visualization for anatomical reduction and rigid fixation of condylar fractures. It ensures favorable functional and esthetic outcomes with minimal complications, establishing it as a safe and reliable technique for managing condylar and subcondylar fractures.