Used of three different approaches for surgical treatment of adult condylar fracture

doi:10.19438/j.cjoms.2022.02.015

Abstract

Abstract: PURPOSE: This study aimed to evaluate and compare clinical outcomes of three different surgical approaches for adult condylar fractures. METHODS: A total of 46 cases with 48 fracture sites were classified according to the standard of Loukota et al. Condylar fractures of the mandible were managed by open reduction and internal fixation via anterior auricular, retromandibular incision through parotid gland and transoral surgical approaches based on the classification. RESULTS: Dental occlusion,mandibular movement,mouth opening,and anatomic reduction were restored in all 46 patients with condylar fractures. No patient showed condylar head resorption. CONCLUSIONS: Different surgical approaches can achieve satisfactory outcomes according to different types of adult condylar fractures.

Key words: Adult, Condylar fracture, Surgical approach

CLC Number:

R782.4

GAO Zhi-biao, WANG Lei, XIAO Xia, GAO Duo-duo. Used of three different approaches for surgical treatment of adult condylar fracture[J]. China Journal of Oral and Maxillofacial Surgery, 2022, 20(2): 184-187.

References

[1] Singh V, Bhagol A, Coel M, et al.Outcomes of open versus closed treatment of mandibular subcondylar fractures: a prospective randomized study[J]. J Oral Maxilofac Surg, 2010, 68(6): 1303-1309.
[2] Loukota RA, Eckelt U, Rasse M.Subclassification of fractures of the condylar process of the mandible[J]. Br J of Oral Maxillofacial Surg, 2005, 43(1): 72-73.
[3] Song KS, Kang CH, Min BW, et al.Closed reduction and internal fixation of displaced unstable lateral condylar fractures of the humerus in children[J]. J Bone Joint Surg Am, 2008, 90(12): 2637-2681.
[4] 张益, 孙勇刚. 颌骨骨折坚固内固定 [M]. 北京: 北京医科大学出版社, 2003: 188-189.
[5] 陈建平. 下颌骨髁突纵向骨折手术径路的改良[J]. 医学临床研究, 2006, 23(1): 28-30.
[6] 储志强, 张兴安, 马详平. 髁突骨折耳垂后下径路内固定的临床观察[J].口腔医学, 2008, 28(11): 576-576.
[7] 周洪, 丁加根, 陆伟. 下颌骨髁突骨折手术进路和固定方式的回顾性研究[J]. 临床口腔医学杂志, 2005, 21(6): 351-353.
[8] Yano T, Okazaki M, Yamaguchi K, et al.Anatomy of the middle temproal vein: implications for skull-base and craniofacial recon-struction using free flaps[J]. Plast Reconstr Surg, 2014, 134(1): 92-101.
[9] Vesnaver A.Open reduction and internal fixation of intra-aricular fractures of the mandibular condyle: our first experiences[J]. J Oral Maxilofac Surg, 2008, 66(10): 2123-2129.
[10] 韩前超, 徐正茂, 晏全红, 等. 髁突骨折开放手术方法的回顾性分析[J]. 口腔医学研究, 2010, 26(3): 428-429.
[11] 樊星, 肖霞, 高志彪, 等. 髁突颈下部骨折口内入路与颌后入路的临床比较[J]. 中国口腔颌面外科杂志, 2020, 18(2): 151-154.
[12] Hackenberg B, Lee C, Caterson EJ.Management of subcondylar mandible fractures in the adult patient[J]. J Craniofac Surg, 2014, 25(1): 166-171.
[13] Blumer M, Guggenbuhl T, Wagner MEH, et al. Outcome of surgically treated fractures of the condylar process by an endoscopic assisted transoral approach[J]. J Oral Maxilofac Surg, 2019, 77(1): 133.e1-133.e9.
[14] 王旭东, 沈国芳, 徐兵, 等. 内镜辅助髁突下骨折的复位与内固定[J].中国口腔颌面外科杂志, 2009, 7(1): 8-14.

[1]	WANG Bo, YU Hong-bo, XIA Yun-yui, FANG Bing, GUO Qiu-man. Long-term effectiveness of periodontal micro-osteotomy assisted orthodontic treatment in adult patients with primary alveolar defect [J]. China Journal of Oral and Maxillofacial Surgery, 2022, 20(3): 225-229.
[2]	JIANG Yan, WEN Yue-jin, JIANG Can-yang, HUANG Jian-ping, SHI Bin, ZHU Xiao-feng, HUANG Li, LIN Li-song. Clinical study of condylar fracture with external auditory canal fracture in 34 patients [J]. China Journal of Oral and Maxillofacial Surgery, 2020, 18(4): 361-364.
[3]	FAN Xing, XIAO Xia, GAO Zhi-biao, BAI Zhen-xi.. Clinical investigation of transoral internal fixation for subcondylar fracture：a comparative study FAN Xing, XIAO Xia, GAO Zhi-biao, BAI Zhen-xi. [J]. China Journal of Oral and Maxillofacial Surgery, 2020, 18(2): 151-154.
[4]	REN Rong, CAI Bo-lei, ZHI Yin, SI Jia-wen, ZHANG Jian-fei, SHI Jun.. Modified surgical method for diacapitular condylar fractures in 38 consecutive patients [J]. China Journal of Oral and Maxillofacial Surgery, 2018, 16(3): 242-247.
[5]	JIAO Zi-xian, WANG Xiang-yu, ZHANG Xiao-hu, YANG Chi. A modified tragus incision with vascular-guided multilayer approach to temporomandibular joint [J]. China Journal of Oral and Maxillofacial Surgery, 2018, 16(1): 41-43.
[6]	ZHANG Xin-yun, LI Chan, LI Hong-fa. Study about the relationship between the structural features of adult temporomandibular joint osteoarthritis and Helkimo index by cone-beam CT [J]. China Journal of Oral and Maxillofacial Surgery, 2018, 16(1): 64-68.
[7]	GUO Zhong-jun, ZHOU Hong, LI Rui-chun, HAN Feng-qin. Clinical effect of micro screw implant anchorage in the treatment of adult patients with double jaw protrusion [J]. China Journal of Oral and Maxillofacial Surgery, 2017, 15(6): 519-523.
[8]	WANG Bao-li, HE Dong-mei, YANG Chi, CAI Yi-hua, CAI Xie-yi, YANG Xiu-juan, MA Zhi-gui. Factors affecting the outcomes of non-surgical treatment of intracapsular condylar fractures [J]. China Journal of Oral and Maxillofacial Surgery, 2016, 14(3): 228-233.
[9]	WANG Bo, YU Hong-bo, SUN Liang-yan, SHEN Guo-fang, WANG Xu-dong, FANG Bing, GUO Qiu-man. Long-term effect of augmented corticotomy assisted orthodontic treatment for adult patients with moderate to severe periodontitis [J]. China Journal of Oral and Maxillofacial Surgery, 2016, 14(3): 234-238.
[10]	WANG Fan, YANG Qing-fu. Application of improved condylectomy in adult intracapsular fracture of mandibular condyle [J]. China Journal of Oral and Maxillofacial Surgery, 2016, 14(1): 66-68.
[11]	TANG Yan-mei, XU Bin, NIE Ping, WANG Xiao-ling, XUE Xiao-chen, ZHU Min.. Closed treatment of pediatric dislocated intracapsular condylar fractures with mandibular retrusion using orthodontic appliance [J]. China Journal of Oral and Maxillofacial Surgery, 2015, 13(6): 550-553.
[12]	ZHOU Shang-hui, ZHANG Chen-ping, LI Da-qing.. Application of robot-assisted neck dissection [J]. China Journal of Oral and Maxillofacial Surgery, 2015, 13(6): 570-573.
[13]	CAI Yi-hua, HE Dong-mei, YANG Chi, RAO Jian, DONG Min-Jun. Evaluation of soft tissue healing after intracapsular condylar fracture by MRI [J]. China Journal of Oral and Maxillofacial Surgery, 2015, 13(2): 155-160.
[14]	ZHANG Da-ming, CHEN Wei-liang, LIN Zhao-yu, ZHOU Bin, HUANG Zhi-quan, WANG You-yuan. A post submandibular approach together with osteotomy in the vertical ramus outside of the mandibular foramen in treatment of tumors invading parapharyngeal space [J]. China Journal of Oral and Maxillofacial Surgery, 2014, 12(3): 243-246.
[15]	CAI Yi-hua, LU Chuan, HE Dong-mei, YANG Chi. Treatment of bilateral intracapsular condylar fracture displaced superolaterally with symphysis fracture in children: report of 1 case [J]. China Journal of Oral and Maxillofacial Surgery, 2014, 12(3): 281-284.