Intracorporeal reduction of condylar fracture using both pedicled condylar and seperated ramal fragments after vertical ramal osteotomy
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
The aim of this study is to introduce a surgical technique that can maintain blood supply to prevent condylar resorption in the extracorporeal reduction of condylar fracture. Neither the medial pterygoid muscle on the ramal bone nor the lateral pterygoid muscle on the condylar fragment was detached after vertical ramal osteotomy. Thus, reduction was performed in the intracorporeal state. Therefore, blood supply was expected to be maintained to the fragments of both the condylar and ramal bones. On postoperative radiographs, the anatomical outline of the fractured condyle was well restored, and the occlusion was stable. In the unilateral case, there were no signs of mandibular condylar resorption until postoperative 3 weeks. In the 2 bilateral cases, condylar displacements with plate fractures and screw loosening were observed at postoperative 1 month or 5 months, but radiodensity at the displaced fracture site increased during the follow-up period. Finally, complete remodeling of the condylar fragments with restored anatomic appear-ance was observed on 8-month or 2-year follow-up radiographs. All cases exhibited good healing aspects with no signs or symptoms of mandibular condylar dysfunction during the postoperative remodeling period after intracorporeal reduction of condylar fracture.
Abstract
The aim of this study is to introduce a surgical technique that can maintain blood supply to prevent condylar resorption in the extracorporeal reduction of condylar fracture. Neither the medial pterygoid muscle on the ramal bone nor the lateral pterygoid muscle on the condylar fragment was detached after vertical ramal osteotomy. Thus, reduction was performed in the intracorporeal state. Therefore, blood supply was expected to be maintained to the fragments of both the condylar and ramal bones. On postoperative radiographs, the anatomical outline of the fractured condyle was well restored, and the occlusion was stable. In the unilateral case, there were no signs of mandibular condylar resorption until postoperative 3 weeks. In the 2 bilateral cases, condylar displacements with plate fractures and screw loosening were observed at postoperative 1 month or 5 months, but radiodensity at the displaced fracture site increased during the follow-up period. Finally, complete remodeling of the condylar fragments with restored anatomic appear-ance was observed on 8-month or 2-year follow-up radiographs. All cases exhibited good healing aspects with no signs or symptoms of mandibular condylar dysfunction during the postoperative remodeling period after intracorporeal reduction of condylar fracture.
참고문헌 (12)
- 김민근, "Modified Extracorporeal Reduction of the Mandibular Condylar Neck Fracture", Maxillofacial Plastic Reconstructive Surgery, 36(1), pp.30~36 (2014), 대한악안면성형재건외과학회[DOI]
- Hidding J, "Surgical versus non-surgical treatment of fractures of the articular process of the mandible", J Craniomaxillofac Surg, 20, pp.345~347 (1992)
- Zide MF, "Indications for open reduction of mandibular condyle fractures", J Oral Maxillofac Surg, 41, pp.89~98 (1983)
- Zide MF, "Open reduction of mandibular condyle fractures", Clin Plast Surg, 16, pp.69~76 (1989)
- Silvennoinen U, "Occlusal and temporomandibular joint disorders in patients with unilateral condylar fracture. A prospective one-year study", Int J Oral Maxillofac Surg, 27, pp.280~285 (1998)
- Ellis E 3rd, "Surgical complications with open treatment of mandibular condylar process fractures", J Oral Maxillofac Surg, 58, pp.950~958 (2000)
- Gupta MV, "Extracorporeal fixation of displaced mandibular condylar fracture: viable option", Med J Armed Forces India, 65, pp.229~231 (2009)
- Davis BR, "Free-grafting of mandibular condyle fractures: clinical outcomes in 10 consecutive patients", Int J Oral Maxillofac Surg, 34, pp.871~876 (2005)
- Pereira MD, "Surgical treatment of the fractured and dislocated condylar process of the mandible", J Craniomaxillofac Surg, 23, pp.369~376 (1995)
- Iizuka T, "Severe bone resorption and osteoarthrosis after miniplate fixation of high condylar fractures. A clinical and radiologic study of thirteen patients", Oral Surg Oral Med Oral Pathol, 72, pp.400~407 (1991)
- Park JM, "Comparative study of the prognosis of an extracorporeal reduction and a closed treatment in mandibular condyle head and", or neck fractures, 2010, pp.68, 2986~2993
- Tominaga K, "Biomechanical evaluation of different types of rigid internal fixation techniques for subcondylar fractures", J Oral Maxillofac Surg, 64, pp.1510~1516 (2006)
