• Journal of Trauma and Injury
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• 제31권2호
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• pp.96-102
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• 2018

Ipsilateral fractures of proximal femur with shaft and condylar region are very rare. Current concept of management is based on fixation of each fracture as independent entity using separate fixation modalities for proximal and distal parts of femur. However, we considered that antegrade femoral nailing with cephalomedullary screw fixation is a good option for ipsilateral multi-level femoral fractures. Here, we present an experience of satisfactory treatment for ipsilateral femoral neck fracture, subtrochanteric fracture, comminuted shaft fracture with supracondylar fracture following road traffic accident.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권6호
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• pp.559-564
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• 2006

According to the development of operation technique and biologic materials, oromaxillofacial surgery department have used many kinds of metal and biologic materials in ORIF and plastic surgery. In maxillofacial fracture, ORIF with metal plate and screw have short healing period and good prognosis. But ORIF with metal materials have many complications as maxillofacial abnormal growth, screw loosening, bone malunion. And metal materials have not used in infection site. The purpose of this study is to evaluate the clinical value of 10 condylar fracture patients operated with absorbable screw at Wonkwang university. Ten patients(8 males, 2 female, mean aged 28) who had mandibular condyle process fracture treated with PLLA implants(poly-l-lactide) was recalled for follow-up clinical and radiologic examination for 10 years. Mouth opening recorvered to more than 35mm and occlusion was stable in all patients. All fractured mandibular condyles showed anatomic good reduction and long-term stability with the use of resorbable miniplates and screw. Bone healing was satisfactory in all patients, and there was no evidence of abnormal resorption of condylar process.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제27권3호
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• pp.204-208
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• 2001

The purpose of this study is to examine the change of enzymeimmuno-assay for $prostaglandinE_2$ in the synovial fluid lavage specimen of patients with mandibular fracture patients without condylar fracture. For this study, fourteen patients (eight males, six females) with mandibular fractures without condylar fracture was investigated to analyse the synovial fluid from upper temporomandibular joint cavities. Synovial fluid was collected from TMJ cavities of mandibular fracture patients before open reduction and after one week of open reduction, and then stored in liquid nitrogen tank after centrifuge. Two synovial fluid lavage samples of TMJs of 2 asymptomatic served as normal controls referred from other data. The concentrations of $PGE_2$ were measured by use of $PGE_2$ EIA System ($Amersham^{(R)}$). The following results were obtained: 1) In nine patients, the concentrations of $PGE_2$ are lower after open reduction than before. 2) In three patients, the concentrations of $PGE_2$ are higher after open reduction than before. 3) There was no statistical significant between the preoperative group and postoperative 7 days (p>0.05), but there was some difference between the two groups. In conclusion, the results suggest that $PGE_2$ probably does not play as important role in the harm of TMJ.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제40권2호
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• pp.76-82
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• 2014

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.

• 대한소아치과학회지
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• 제47권1호
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• pp.1-8
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• 2020

본 연구의 목적은 소아 청소년에서 발생한 하악 과두 골절의 빈도, 원인, 골절의 임상적 양상 및 치료 방법에 대한 후향적 분석을 통해 연령에 따른 하악 과두 골절의 임상적 특징 및 치료방법을 조사하는 것이었다. 최근 10년간 아주대학교 치과병원에서 하악 과두 골절로 진단받고 치료받은 만 15세 이하의 환자 44명을 대상으로 후향적 분석을 시행하였다. 하악골 골절 중 하악 과두 골절의 빈도는 환아의 연령이 어릴수록 높았다. 하악 과두 골절의 원인으로 넘어짐의 비율이 가장 높았다. 만 4 - 7세 군에선 과두부(condyle head) 골절이 91.7%를 차지하였으며, 연령이 증가할수록 과두경부(condyle neck) 골절 비율이 증가하였다. 하악 과두 골절 환아의 54.5%에서 하악 정중부 골절이 동반되었으며, 정중부 골절이 동반된 경우 구치부 치아 손상 빈도는 하악 과두 골절 단독인 경우에 비해 높았다. 44명 환아 중 43명에서 보존적 치료가 시행되었으며, 양측 과두의 심각한 골편 변위를 가진 1명 환아에서 관혈적 수술이 시행되었다. 본 연구 결과는 소아 청소년에서 발생한 하악 과두 골절의 진단 및 치료 계획 수립에 의미있는 자료로 적용될 수 있을 것이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제38권
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• pp.24.1-24.7
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• 2016

Background: This study aimed to evaluate the structural changes of temporomandibular joint immediately after condylar fractures with magnetic resonance imaging (MRI). Method: We evaluated 34 subjects of condylar fractures with MRI. The position, shape, and signal intensity of the condyle, disc, and retrodiscal tissue were analyzed with MR images. Results: Immediately after trauma, the disc was displaced with the fractured segment in almost all cases. And, the changes of signal intensity at the retrodiscal tissue were found but less related to the degree of fracture displacement. And, the high signals were observed almost at all fractured joint spaces and even at some contralateral joints. Conclusions: The displaced disc as well as the increased signal intensity of the joint space, condylar head, and retrodiscal tissue demands more attention to prevent the possible sequela of joint.

• Imaging Science in Dentistry
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• 제41권2호
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• pp.53-57
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• 2011

Purpose : The purpose of this study was to evaluate the diagnostic performance of dental students in detection of mandibular condyle fractures and the effectiveness of reference panoramic images. Materials and Methods : Forty-six undergraduates evaluated 25 panoramic radiographs for condylar fractures and the data were analyzed through receiver operating characteristic (ROC) analysis. After a month, they were divided into two homogeneous groups based on the first results and re-evaluated the images with (group A) or without (group B) reference images. Eight reference images included indications showing either typical condylar fractures or anatomic structures which could be confused with fractures. Paired t-test was used for statistical analysis of the difference between the first and the second evaluations for each group, and student�fs t-test was used between the two groups in the second evaluation. The intra- and inter-observer agreements were evaluated with Kappa statistics. Results : Intra- and inter-observer agreements were substantial (k=0.66) and moderate (k=0.53), respectively. The area under the ROC curve (Az) in the first evaluation was 0.802. In the second evaluation, it was increased to 0.823 for group A and 0.814 for group B. The difference between the first and second evaluations for group A was statistically significant (p<0.05), however there was no statistically significant difference between the two groups in the second evaluation. Conclusion : Providing reference images to less experienced clinicians would be a good way to improve the diagnostic ability in detecting condylar fracture.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제44권2호
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• pp.73-78
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• 2018

Objectives: The goal of this study was to evaluate the rates of complications, morbidity, and safety with the transparotid approach. Materials and Methods: A retrospective study was conducted and consisted of 53 surgically treated patients in the past five years for low condylar neck and subcondylar fractures. Only patients with malocclusion and who underwent open reduction with internal fixation with the retromandibular transparotid approach were included. The examined parameters were postoperative suboptimal occlusion, deflection, saliva fistula, and facial nerve weakness. Results: Fifty-three patients had an open reduction with internal fixation on 55 sides (41 males, 77.4%; mean age, 42 years [range, 18-72 years]). Four patients (7.5%) experienced transient facial nerve weakness of the marginal mandibular branch, but none was permanent. Four patients had a salivary fistula, and 5 patients showed postoperative malocclusion, where one needed repeat surgery after one year. One patient showed long-term deflection. No other complications were observed. Conclusion: The retromandibular transparotid approach is a safe procedure for open reduction and internal fixation of low condylar neck and subcondylar fractures, and it has minimal complications.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권1호
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• pp.43-48
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• 2010

The mandibular condyle fracture occurs at 15-30% frequency of whole mandibular fracture. The treatment of choice is open reduction or closed reduction. In many cases, closed reduction is preferred for treatment of condylar fracture because it is hard to approach to condyle and there is risk of surgical complications, such as nerve damage in open reduction. Open reduction, however, has some advantages like possibility of anatomical reduction, occlusal stability and rapid functional recovery. Furthermore, it is possible to retain original ramal heights and to decrease deviation during mouth opening. There are many surgical approaches for open reduction of subcondyle fracture. At present, transoral approach using trochar device is tried for effective and minimally invasive method for open reduction of subcondyle fracture. And the authors report the cases of reduction of subcondyle fracture with transoral approach using trochar device.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제15권3호
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• pp.211-216
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• 1993

This is to report functional treatment, as mechano-therapy, of condylar fracture in cases of growing patients. Benoist's appliance was used in 3 cases condylar fractures, provides extraoral elastic forces to external pterygoid muscle. The appliance providing guided exercise of masticatory muscles induces transformative growth of trauma-tic condyles. The results were as follow; 1. Early exercise preventes ankylosis of fractured condyle. 2. Optimal physical exercise therapy induces the normal growth pattern by muscular training and bony remodeling of fractured condyle in children.