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Plastic Surgery International
Volume 2011 (2011), Article ID 421245, 5 pages
http://dx.doi.org/10.1155/2011/421245
Clinical Study

Open Reduction of Subcondylar Fractures Using a New Retractor

1Department of Plastic and Reconstructive Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji, Tokyo 193-0998, Japan
2Department of Plastic and Reconstructive Surgery, Kosei Hospital, 5-25-15 Yayoichou, Nakano, Tokyo 164-0013, Japan

Received 25 April 2011; Revised 16 June 2011; Accepted 16 June 2011

Academic Editor: Hiko Hyakusoku

Copyright © 2011 Akira Sugamata et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Many operative approaches have been described for the open reduction of subcondylar fractures and rigid fixation. However, fracture portions are deep and embedded among facial nerves so that visual surgery in this region is extremely limited. Once the operative field is exposed, the displacement of the condylar head is often dislocated by the anteromedial pull of the lateral pterygoid muscle and the fracture end of the condylar process is pulled up to the mandibular fossa by contraction of the masseter muscle. We made a new retractor to achieve a better field of view. It is possible to pull down the condylar process by opening the tips of the retractor using the specially made wrench system without special effort and keep the condylar process in the same position during reduction. In using this retractor, the fracture stumps were clearly exposed and more easily reposited.