J Korean Assoc Oral Maxillofac Surg.  2014 Apr;40(2):76-82. 10.5125/jkaoms.2014.40.2.76.

A follow-up study on extracorporeal fixation of condylar fractures using vertical ramus osteotomy

• Park SY
• Im JH
• Yoon SH
• Lee DK

• KMID: 1960958
• DOI: http://doi.org/10.5125/jkaoms.2014.40.2.76

Abstract

OBJECTIVES
The aim of this study is to report the results of extracorporeal fixation in patients with mandibular condylar fractures and compare them with the clinical results of conservative treatment.
MATERIALS AND METHODS
The medical records of 92 patients (73 male [M] : 19 female [F], age 13-69 years, mean 33.1 years) treated for condylar fractures at the Department of Oral and Maxillofacial Surgery in Sun Dental Hospital (Daejeon, Korea) from 2007 to 2012 were reviewed. Patients were divided into three groups: group A (23 patients; M : F=18 : 5, age 21-69 years, mean 32.6 years), treated with extracorporeal fixation; group B (30 patients; M : F=24 : 6, age 16-57 years, mean 21.1 years), treated by conventional open reduction; and group C (39 patients; M : F=31 : 8, age 16-63 years, mean 34.4 years), treated with the conservative method ('closed' reduction). Clinical and radiographic findings were evaluated and analyzed statistically.
RESULTS
Occurrence of postoperative condylar resorption correlated with certain locations and types of fracture. In this study, patients in group A (treated with extracorporeal fixation) did not demonstrate significant postoperative complications such as malocclusion, mandibular hypomobility, temporomandibular disorder, or complete resorption of condyle fragments.
CONCLUSION
In superiorly located mandibular condyle fractures, exact reconstruction of condylar structure with the conventional open reduction technique can be difficult due to the limited surgical and visual fields. In such cases, extracorporeal fixation of the condyle using vertical ramus osteotomy may be a better choice of treatment because it results in anatomically accurate reconstruction and low risk of complications.

Keyword

Mandibular fractures; Mandibular condyle; Extracorporeal fixation

MeSH Terms

Female
Follow-Up Studies*
Humans
Male
Malocclusion
Mandibular Condyle
Mandibular Fractures
Medical Records
Osteotomy*
Postoperative Complications
Solar System
Surgery, Oral
Temporomandibular Joint Disorders
Visual Fields

Figure

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  Fig. 1 An illustration of the extracorporeal fixation technique.

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  Fig. 2 Intraoperative photos of extracorporeal fixation.

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  Fig. 3 Measurement technique for condylar resorption. (A: superior point of condyle, B: inferior point sigmoid notch, C: cross point)

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  Fig. 4 Moderate resorption of the condyle after extracorporeal fixation. A. A 71-year-old female patient who was expected to have a lower turnover rate. B. A 50-year-old male patient comminuted fracture. C. A 44-year-old male patient fixed with wiring.

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  Fig. 5 No resorption of the condyle after extracorporeal fixation. A. Preopera-tive panoramic X-ray. A 30-year-old male patient with bilateral condylar head fractures. B. Preoperative computed tomography. C. Postoperative panoramic X-ray. D. Panoramic X-ray after 5 years. E. Clinical photo showing a maximum mouth opening of 38 mm without deviation.

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