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

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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.	馮智強, 楊馳, 何冬梅, 等. 339例下頜骨髁突骨折回顧分析.中國口腔頜面外科雜志, 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, 楊馳.下頜骨髁突骨折的分類及治療.中國實用口腔科雜志, 2010, 3(4): 200-203.
6.	姚政鐸, 何冬梅, 勾洪良.下頜骨髁突骨折的分類及治療進展.中華臨床醫師雜志(電子版), 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.	蔡怡華, 何冬梅, 楊馳, 等.髁突囊內骨折軟組織損傷分類及預后評價.中國口腔頜面外科雜志, 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.	邱亞汀, 楊馳, 王玉良, 等.下頜髁突囊內骨折后關節強直的診斷與手術治療.中國口腔頜面外科雜志, 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.	馮智強, 李凌志, 周志迎, 等.生長期山羊囊內骨折復位術中保留髁突軟骨的重要性及組織學研究.中國口腔頜面外科雜志, 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.微型鈦板聯合側向拉力螺釘技術治療髁突囊內矢狀骨折.局解手術學雜志, 2013, 22(1): 12-14.

1. 馮智強, 楊馳, 何冬梅, 等. 339例下頜骨髁突骨折回顧分析.中國口腔頜面外科雜志, 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, 楊馳.下頜骨髁突骨折的分類及治療.中國實用口腔科雜志, 2010, 3(4): 200-203.
6. 姚政鐸, 何冬梅, 勾洪良.下頜骨髁突骨折的分類及治療進展.中華臨床醫師雜志(電子版), 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. 蔡怡華, 何冬梅, 楊馳, 等.髁突囊內骨折軟組織損傷分類及預后評價.中國口腔頜面外科雜志, 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. 邱亞汀, 楊馳, 王玉良, 等.下頜髁突囊內骨折后關節強直的診斷與手術治療.中國口腔頜面外科雜志, 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. 馮智強, 李凌志, 周志迎, 等.生長期山羊囊內骨折復位術中保留髁突軟骨的重要性及組織學研究.中國口腔頜面外科雜志, 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.微型鈦板聯合側向拉力螺釘技術治療髁突囊內矢狀骨折.局解手術學雜志, 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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