MINI TITANIUM PLATE FOR TREATMENT OF INTRACAPSULAR CONDYLAR FRACTURES_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

FENGZhiqiang ¹ , CHENXufeng ^1,2 , CAOFengdi ^1,2 , LINQiang ^1,2 ,  LAIRenfa ¹

1. The Medical Centre of Stomatology, the First Affiliated Hospital of Jinan University, Guangzhou Guangdong, 510630, P.R.China;
2. Medical School of Jinan University;

Corresponding author：

LAIRenfa, Email: prof.dr.lai@163.com

Keywords：

Intracapsular condylar fracture; Open reduction; Mini titanium plate

DOI：

10.7507/1002-1892.20160068

Video：

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Objective To investigate the effectiveness of mini titanium plate for the treatment of intracapsular condylar fractures-type A. Methods Between March 2013 and July 2015, 22 cases (26 sides) of intracapsular condylar fractures-type A were treated with mini titanium plate through anterior auricular approach. There were 13 males and 9 females, aged from 16 to 32 years (mean, 22.7 years). The disease causes were traffic accident injury in 17 cases, falling injury in 4 cases, and heavy impact injury in 1 case. Five cases had intracapsular condylar fractures-type A only, and the other cases were accompanied with fractures of mandible, maxillary, or other part of jaw. All patients had different degrees of limitation of opening mouth, occlusal disorder, and joint pain, and the maximum opening was 5-16 mm (mean, 8.6 mm). All patients received surgical treatment within 2 to 9 days after injury (mean, 4 days). The clinical dysfunction index (DI) of Helkimo index was used to evaluate the mandibular motor function postoperatively. According to the 4 basic criterion of cure about mandibular condylar fractures by the international consensus conference in 1999, and maximal mouth opening by HE Dongmei et al., the surgical treatment effectiveness was evaluated. Results All wounds healed at stage I, with no infection or other complications. All 22 cases were followed up 5-8 months (mean, 6 months). At 1 week after operation, the coronal spiral CT and three-dimensional reconstruction showed that contraposition of fractures was good, and the condyles located in the articular fossa. At 6 months after operation, the maximum opening was 33-42 mm (mean, 35.7 mm). After operation, 3 cases showed the mandible deflected to the affected side when opening, and limited lateral motion. According to the DI evaluation method in Helkimo index, there were 7 sides of DI grade 0, 18 sides of DI grade I, and 1 side of DI grade II. Based on surgical treatment effect of intracapsular condylar fractures-type A, occlusion recovery was obtained in 19 cases (86.36%), maximum opening degree of≥35 mm in 20 cases (90.91%), no symptoms of joint injury in 19 cases (86.36%), and no serious postoperative complications in 22 cases (100%); 17 cases (77.27%) were in accordance with the above 4 items. Conclusion Mini titanium plate is one of the most effective approaches to treat intracapsular condylar fractures-type A.

Citation： FENGZhiqiang, CHENXufeng, CAOFengdi, LINQiang, LAIRenfa. MINI TITANIUM PLATE FOR TREATMENT OF INTRACAPSULAR CONDYLAR FRACTURES. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(3): 348-352. doi: 10.7507/1002-1892.20160068 Copy

1.	冯智强, 杨驰, 何冬梅, 等. 339例下颌骨髁突骨折回顾分析.中国口腔颌面外科杂志, 2009, 7(3): 209-212.
2.	He D, Yang C, Chen M, et al. Intracapsular condylar fracture of the mandible:our classification and open treatment experience. J Oral Maxillofac Surg, 2009, 67(8): 1672-1679.
3.	Helkimo M. Studies on function and dysfunction of the masticatory system. II. Index for anamnestic and clinical dysfunction and occlusal state. Sved Tandlak Tidskr, 1974, 67(2): 101-121.
4.	Bos RR, Ward Booth RP, de Bont LG. Mandibular condyle fractures: a consensus. Br J Oral Maxillofac Surg, 1999, 37(2): 87-89.
5.	何冬梅, 杨驰.下颌骨髁突骨折的分类及治疗.中国实用口腔科杂志, 2010, 3(4): 200-203.
6.	姚政铎, 何冬梅, 勾洪良.下颌骨髁突骨折的分类及治疗进展.中华临床医师杂志(电子版), 2012, 6(6): 118-121.
7.	Sharif MO, Fedorowicz Z, Drews P, et al. Interventions for the treatment of fractures of the mandibular condyle. Cochrane Database Syst Rev, 2010, (4): CD006538.
8.	Ellis E 3rd. Complications of mandibular condyle fractures. Int J Oral Maxillofac Surg, 1998, 27(4): 255-257.
9.	蔡怡华, 何冬梅, 杨驰, 等.髁突囊内骨折软组织损伤分类及预后评价.中国口腔颌面外科杂志, 2015, 13(2): 155-160.
10.	Duan DH, Zhang Y. A clinical investigation on disc displacement in sagittal fracture of the mandibular condyle and its association with TMJ ankylosis development. Int J Oral Maxillofac Surg, 2011, 40(2): 134-138.
11.	邱亚汀, 杨驰, 王玉良, 等.下颌髁突囊内骨折后关节强直的诊断与手术治疗.中国口腔颌面外科杂志, 2006, 4(2): 97-101.
12.	Hlawitschka M, Loukota R, Eckelt U. Functional and radiological results of open and closed treatment of intracapsular (diacapitular) condylar fractures of the mandible. Int J Oral Maxillofac Surg, 2005, 34(6): 597-604.
13.	He D, Ellis E 3rd, Zhang Y. Etiology of temporomandibular joint ankylosis secondary to condylar fractures: the role of concomitant mandibular fractures. J Oral Maxillofac Surg, 2008, 66(1): 77-84.
14.	Neff A, Kolk A, Horch HH. Position and mobility of the articular disk after surgical management of diacapitular and high condylar dislocation fractures of the temporomandibular joint. Mund Kiefer Gesichtschir, 2000, 4(2): 111-117.
15.	He D, Yang C, Chen M, et al. Effects of soft tissue injury to the temporomandibular joint: report of 8 cases. Br J Oral Maxillofac Surg, 2013, 51(1): 58-62.
16.	Vesnaver A. Open reduction and internal fixation of intra-articular fractures of the mandibular condyle: our first experiences. J Oral Maxillofac Surg, 2008, 66(10): 2123-2129.
17.	Feng Z, Li L, He D, et al. Role of retention of the condylar cartilage in open treatment of intracapsular condylar fractures in growing goats: three-dimensional computed tomographic analysis. Br J Oral Maxillofac Surg, 2012, 50(6): 523-527.
18.	冯智强, 李凌志, 周志迎, 等.生长期山羊囊内骨折复位术中保留髁突软骨的重要性及组织学研究.中国口腔颌面外科杂志, 2013, 11(6): 459-467.
19.	Meng F, Hu K, Kong L, et al. Veterinary and radiological evaluations of open and closed treatment of type B diacapitular (intracapsular) fractures of the mandibular condyle in sheep. Br J Oral Maxillofac Surg, 2010, 48(6): 448-452.
20.	Koltai PJ, Solares CA, Mascha EJ, et al. Intracapsular partial tonsillectomy for tonsillar hypertrophy in children. Laryngoscope, 2002, 112(8 Pt 2 Suppl 100): 17-19.
21.	王翔, 郭家平, 董青山, 等.微型钛板联合侧向拉力螺钉技术治疗髁突囊内矢状骨折.局解手术学杂志, 2013, 22(1): 12-14.

1. 冯智强, 杨驰, 何冬梅, 等. 339例下颌骨髁突骨折回顾分析.中国口腔颌面外科杂志, 2009, 7(3): 209-212.
2. He D, Yang C, Chen M, et al. Intracapsular condylar fracture of the mandible:our classification and open treatment experience. J Oral Maxillofac Surg, 2009, 67(8): 1672-1679.
3. Helkimo M. Studies on function and dysfunction of the masticatory system. II. Index for anamnestic and clinical dysfunction and occlusal state. Sved Tandlak Tidskr, 1974, 67(2): 101-121.
4. Bos RR, Ward Booth RP, de Bont LG. Mandibular condyle fractures: a consensus. Br J Oral Maxillofac Surg, 1999, 37(2): 87-89.
5. 何冬梅, 杨驰.下颌骨髁突骨折的分类及治疗.中国实用口腔科杂志, 2010, 3(4): 200-203.
6. 姚政铎, 何冬梅, 勾洪良.下颌骨髁突骨折的分类及治疗进展.中华临床医师杂志(电子版), 2012, 6(6): 118-121.
7. Sharif MO, Fedorowicz Z, Drews P, et al. Interventions for the treatment of fractures of the mandibular condyle. Cochrane Database Syst Rev, 2010, (4): CD006538.
8. Ellis E 3rd. Complications of mandibular condyle fractures. Int J Oral Maxillofac Surg, 1998, 27(4): 255-257.
9. 蔡怡华, 何冬梅, 杨驰, 等.髁突囊内骨折软组织损伤分类及预后评价.中国口腔颌面外科杂志, 2015, 13(2): 155-160.
10. Duan DH, Zhang Y. A clinical investigation on disc displacement in sagittal fracture of the mandibular condyle and its association with TMJ ankylosis development. Int J Oral Maxillofac Surg, 2011, 40(2): 134-138.
11. 邱亚汀, 杨驰, 王玉良, 等.下颌髁突囊内骨折后关节强直的诊断与手术治疗.中国口腔颌面外科杂志, 2006, 4(2): 97-101.
12. Hlawitschka M, Loukota R, Eckelt U. Functional and radiological results of open and closed treatment of intracapsular (diacapitular) condylar fractures of the mandible. Int J Oral Maxillofac Surg, 2005, 34(6): 597-604.
13. He D, Ellis E 3rd, Zhang Y. Etiology of temporomandibular joint ankylosis secondary to condylar fractures: the role of concomitant mandibular fractures. J Oral Maxillofac Surg, 2008, 66(1): 77-84.
14. Neff A, Kolk A, Horch HH. Position and mobility of the articular disk after surgical management of diacapitular and high condylar dislocation fractures of the temporomandibular joint. Mund Kiefer Gesichtschir, 2000, 4(2): 111-117.
15. He D, Yang C, Chen M, et al. Effects of soft tissue injury to the temporomandibular joint: report of 8 cases. Br J Oral Maxillofac Surg, 2013, 51(1): 58-62.
16. Vesnaver A. Open reduction and internal fixation of intra-articular fractures of the mandibular condyle: our first experiences. J Oral Maxillofac Surg, 2008, 66(10): 2123-2129.
17. Feng Z, Li L, He D, et al. Role of retention of the condylar cartilage in open treatment of intracapsular condylar fractures in growing goats: three-dimensional computed tomographic analysis. Br J Oral Maxillofac Surg, 2012, 50(6): 523-527.
18. 冯智强, 李凌志, 周志迎, 等.生长期山羊囊内骨折复位术中保留髁突软骨的重要性及组织学研究.中国口腔颌面外科杂志, 2013, 11(6): 459-467.
19. Meng F, Hu K, Kong L, et al. Veterinary and radiological evaluations of open and closed treatment of type B diacapitular (intracapsular) fractures of the mandibular condyle in sheep. Br J Oral Maxillofac Surg, 2010, 48(6): 448-452.
20. Koltai PJ, Solares CA, Mascha EJ, et al. Intracapsular partial tonsillectomy for tonsillar hypertrophy in children. Laryngoscope, 2002, 112(8 Pt 2 Suppl 100): 17-19.
21. 王翔, 郭家平, 董青山, 等.微型钛板联合侧向拉力螺钉技术治疗髁突囊内矢状骨折.局解手术学杂志, 2013, 22(1): 12-14.

Chinese Journal of Reparative and Reconstructive Surgery

MINI TITANIUM PLATE FOR TREATMENT OF INTRACAPSULAR CONDYLAR FRACTURES

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