Maxillofacial Plastic and Reconstructive Surgery

Korean Association of Maxillofacial Plastic and Reconstructive Surgeons (대한악안면성형재건외과학회)
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CLINICAL EVALUATION OF TREATMENT OUTCOME OF PLATING TECHNIQUE OF FIXATION FOR MANDIBULAR CONDYLAR FRACTURE

하악 과두 골절의 관혈적 정복시 고정 방법에 따른 임상적 평가

  • Son, Jung-Hee (Department of Oral & Maxillofacial Surgery, School of Dentistry, Kyungpook National University) ;
  • Park, Ji-Hwa (Department of Oral & Maxillofacial Surgery, School of Dentistry, Kyungpook National University) ;
  • Kim, Chin-Soo (Department of Oral & Maxillofacial Surgery, School of Dentistry, Kyungpook National University) ;
  • Byun, Ki-Jung (Department of Dentistry & Oral Surgery, College of Medicine, Ulsan University)
  • 손정희 (경북대학교 치과대학 구강악안면외과학교실) ;
  • 박지화 (경북대학교 치과대학 구강악안면외과학교실) ;
  • 김진수 (경북대학교 치과대학 구강악안면외과학교실) ;
  • 변기정 (울산대학교 의과대학 치과 구강악안면외과학교실)
  • Published : 2005.03.31
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Abstract

The purpose of this study was to compare a sample of patients who had condylar fractures treated with open reduction using different plating techniques, to evaluate which plating technique is useful for stable fixation for fractures of the mandibular condyle and to evaluate effectiveness of resorbable miniplate. There were 60 patients (41 males, 19 females) whose condylar fractures were treated with open reduction. Rigid fixation was performed with a single miniplate, double miniplate ot one miniplate & one microplate and single resorbable plate. All patients remained intermaxillary fixation for 1 week postoperatively. Active physiotherapy was started after 2 weeks postoperatively. Radiographic evaluation (plate fracture, plate bending, screw loosening, displacement of condyle etc.) was performed at pre-operative, immediate, 2 weeks, 1 month, 3 months, 6 months after surgery. Clinical evaluation included degree of mouth opening, occlusion, mandibular lateral excursion, infection and facial nerve paralysis. In radiographic evaluation, displacement of fractured condylar segment associated with plate bending or screw loosening were showed 6 cases and 3 cases for single miniplate system and resorbable miniplate system. There was no patients who have this problem on double miniplate system. The results revealed that the application of two miniplates were more recommendable than single miniplates. When we select resorbable miniplate system, we should consider the type of fractures, post-operative treatment protocol and surgical technique.

Keywords

References

  1. Tasanen A, Lamberg MA : Transosseous wiring in the treatment of condylar fractures of mandible. J Maxillofac Surg 4 : 200, 1976 https://doi.org/10.1016/S0301-0503(76)80036-7
  2. Blanc JL, Lagier JP, Gras R, Bremond D, Belloni D : Condylar fractures sequelae through our clinical eaperience and medical expertise. Rev Stomatol Chir Maxillofac 86 : 29, 1985
  3. Sang-Han Lee, Hyun-Jung Jang, Doo-Won Cha et al : Clinical study on Facial Bone Fractures. J Korean Association of Maxillofacial Plastic & Reconstructive surgery 23 : 40, 2001
  4. Ellis E 3rd, Reynolds ST, Park HS : A method to rigidly fix high condylar fractures. Oral Surg Oral Med Oral Pathol 68:369, 1989 https://doi.org/10.1016/0030-4220(89)90130-8
  5. Messer EJ : A simplified method of fixation of the fractured mandibular condyle. J Oral Surg 30 : 442, 1972
  6. Haug RH, Peterson GP, Goltz M : A biomechnayanical evaluation of mandibular condyle fracture plating tschniques. J Oral Maxillofac Surg 29 : 73, 2000
  7. Choi BH, Kim KN, Kim HL, et al : Evaluation of condylar neck fracture plating techniques. J Craniomaxillofac Surg 27 : 109, 1999 https://doi.org/10.1016/S1010-5182(99)80023-7
  8. Hammer B, Schier P, Prein J : Osteosynthesis of condylar neck fractures : a review of 30 patients British J Oral Maxillofac Surg 35 : 288, 1997 https://doi.org/10.1016/S0266-4356(97)90050-4
  9. Choi BH, Yi CK, Yoo JH : Clinical evaluation of 3 types of plate osteosynthesis for fixation of condylar neck fractures. J Oral Maxillofac Surg 59 : 734, 2001 https://doi.org/10.1053/joms.2001.24283
  10. Rallis G, Mourouzis C : Plate osteosysthesis of condylar fractures: A retrospective study of 45 patients. Quintessence International 34 : 45, 2003
  11. Araujo M, Waite Lwmons JE : Strength analysis of Le Fort I Osteotomy fixation: Titanium versus resorbable plates. J Oral Maxillofac Surg 2001, 59:1034-1039 https://doi.org/10.1053/joms.2001.25832
  12. Edwards RC, Kiely KD, Eppley BL : Fixation of bimaxillary osteotomy with resorbable plates and screws: Experience in 20 consecutive cases. J Oral Maxillofac Surg 59 : 271, 2001 https://doi.org/10.1053/joms.2001.20988
  13. Norholt SE, Pederson TK, Jensen J : Le Fort I miniplate osteosynthesis: a randomized, prospective study comparing resorbable PLLA/PGA with titanium. Int. J Oral Maxillofac Surg 33 : 245, 2004 https://doi.org/10.1006/ijom.2003.0505
  14. Kitagawa Y, Sano K : Transoral Osteosysthesis at the Mandibular Ramus and Subcondyle using Angular Screwing Instrument and Biodegradable Miniplate system. J Oral Maxillofac Surg 62 : 1041, 2004 https://doi.org/10.1016/j.joms.2004.01.022
  15. Spiessle B, Schroll K : Gelenfortsatz und Gelenkkoefchenfrak turen, in Nigst H (ed): Spezielle Frrakturen und Luxationslehre BD. I/I.Stuttgart, Germany, Thieme, 1972
  16. Zide MF, Kent JN : Indication for open reduction of mandibular condyle fractures. J Oral Maxillofac Sur 41 : 89, 1983 https://doi.org/10.1016/0278-2391(83)90214-8
  17. Throckmorton GS, Dechow PC : In vitro strain measurements in the condylar process of the human mandible. Arch Oral Biol 39 : 853, 1994 https://doi.org/10.1016/0003-9969(94)90017-5
  18. Chossergros C, Cheynet F, Blanc JL : Short retromandibular approach of subcondylar fractures: Clinical and radiologic long-term evaluation. Oral Surg Oral Med Pathol Oral Radiol Endo 82 : 248, 1996 https://doi.org/10.1016/S1079-2104(96)80347-7
  19. Eckelt U, Rasse M : Clinical radiographic and axiographic control after traction-screw osteosysthesis of fractures of the mandibular condyle region. Rev Stomatol Chir Maxillofac 96 : 158, 1995
  20. Tasanen A, Lamberg MA : Transosseous wiring in the treatment of condylar fractures of the mandible. J Oral Maxillofac Surg 4 : 200, 1976
  21. Pietrzk WS, Sarver DR, Verstynen ML : Bioabsorbable polymer science for the practicing surgeon. J Craniofac Surg 8 : 87, 1997 https://doi.org/10.1097/00001665-199703000-00004
  22. Edwards RC, Kiely KD, Eppley BL : The fate of resorbable polyL-lactic/ polyglycoloic acid bone fixation device in orthognathic surgery. J Oral Maxillofac Surg 59 : 19, 2001 https://doi.org/10.1053/joms.2001.19267
  23. Landes CA, Kriener S : Resorbable plate osteosysthesis of saggital split osteotomies with major bone movement. Plast Reconstr Surg 111: 1828, 2001 https://doi.org/10.1097/01.PRS.0000056867.28731.0E
  24. Landes CA, Kriener S, Menzer M, et al : Resorbable plate osteosysthesis of dislocated or pathologic mandibular fractures: A prospective clinical trial of two amorphous L-/DLlactide copolymer 2-mm miniplate systems. Plast Reconstr Surg 111 : 601, 2003 https://doi.org/10.1097/01.PRS.0000041942.36666.4F
  25. Suzuki T, Kawamura H : Resorbable Poly-L-lactide plates and screws for the treatment of madibular condylar process fractures. J Oral Maxillofac Surg 2004, 1 : 919, 2004