Transosseous Wiring of Fracture Condyle of Mandible
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Abstract
This article is a report study for the management of the fracture of mandibular condyle in Maharat Nakhon Ratchasima Hospital that come into my service between October 1989 to January 1995.
There are 21 cases, aged between 14-54 years old; 15 males, 6 female. The most common cause is from motorcycle accident 13 cases, car accident 4 cases, falling 4 cases. The bilateral condylar fracture were found 8 cases, the others 13 cases were unilateral condylar fracture. The fracture dislocation were found in 4 cases; 3 cases were bilateral fracture dislocation; 1 cases was unilateral fracture dislocation. The fracture symphysis or parasymphysis were found together with condylar fracture in 7 cases; 5 cases were found together with bilateral condylar fracture and 2 cases were found together with unilateral condylar fracture. There were 3 cases of bilateral condylar fracture dislocation associate with fracture symphysis. Among 21 cases of condylar fracture, 15 cases need open reduction internal fixation of the fracture condyle, only 3 cases that need intermaxilary fixation only. Open reduction and internal fixation of 19 condylar fractures were done in15 cases via preauricular incision and fixation by transosseous wiring technique. For the fracture symphysis or paraphysis 7 cases, the open reduction and internal fixation were done in 3 cases, using monocortical interosseous wiring alone 2 cases and monocortical interosseous wiring together with metacarpal dynamic compression plate in 1 case. The other 4 cases of symphyseal fracture need no open reduction and internal fixation due to the stable fracture site after the intermaxillary fixation were applied. The intermaxillary fixation was applied for 3 week in cases of fracture without dislocation, and the lower arch bar was retained for another 3 weeks longer. In case of fracture and dislocation the intermaxillary fixation was applied for only 1 week to prevent stiffness of the temporo mandibular joint. The result was satisfy in all cases, with acceptable occlusion, no pain no infection. Minimal complication that found were temporally frontal and orbital branches of facial nerve palsy in 2 cases which all complete recover in 3 months, and a case of unilateral fracture dislocation that is found trismus after intermaxillary fixation for 3 weeks, that can be resolved by post-op dilatation for one time.
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References
Thoma KH. Fractures and fracture dislocation of the mandibular condyle: a method for open reduction and internal wiring and one for skeletal fixation , with a report of 32 cases. J Oral Surg 1945;3:3.
Henny FA.A teachnique for open reduction of fractures of the mandibular condyle, J Oral Surg 1951;9:223.
Nesser EJ, A simplified method for fixation of the fractured mandibular condyle,J Oral surg 1972;30:442.
Peteers RA,Caldwell JB,Olsen TW.A technique for open reduction of subcondylar fractures.Oral Surg Oral Med Oral Pathol 1976; 41:273.
Tasanen A,Lamberg MA.Transosseous wiring in the treatment of condylar fractures of the mandible.J Maxillofac Surg 1976;4:200.
Robinson R,Yoon C.New onlay-inlay metal splint for immobilization of mandibular subcondylar fractures.Am J Ssurg 1960;100:845.
Strrphenson KL,Graham WC. The use of the Kirschner pin in fractures of the condyle. Plast Reconstr Surg 1952;10:19.
Vero Dd.Jaw injuries. The use of Kirschner wires to supplement fixation.Br Dent J 1980;149:137.
Lund K. Unusual fracture disloction of the mandibular condyle in a 6 years old girl. Int J Oral Surg 1972;1:53.
Petzel JR.Functionally stable traction-screw osteosynthesis of condylar fractures.J Oral Maxillofac Surg 1982;40:108.
Cadenat H, Combelles R,Boutault F,et al.Osteosynthesis of subcondylar fractures in the adult.Central medullary"up and down"pinning via a temporal approach.J Maxillofac Surg 1983;11:20.
Brown AE,Obeid G. A simplified method for the internal fixation of fracture of the mandibular condyle.Br J Oral Maxillofac Surg 1984;22:125.
Hadjianghelou O.Temporary reconstruction of the lower jaw by condyiar reimplantation: case report.J Maxillofac Surg 1986;14:221.
Rossu G.Arrigoni G.Reimplantation for the mandibular condyle in cases of intraoral resection and reconstruction of the mandible.J Maxilofac Surg 1979;7:1.
Daniels S,Ellis E,Carlson .Histological analysis of costochondral and sternoclavicular grafts in the TMJ of the juvenile monkey.J oral Maxillofac Surg 1987;45:675.
Zide MF, Kent JN. Indication for open reduction of mandibular condyle fractures. J. Oral Maxillofac Surg 1983;41:89.