Surgical evolution in the treatment of mandibular condyle fractures

BMC Surgery

Giacomo De Riu²  Luciano Catalfamo⁵  Fabio Maglitto⁴  Pasquale Piombino⁴  Giovanni Dell’Aversana Orabona⁴  Mici Elidon⁵  Gianmauro Liberatore³  Evaristo Belli¹ 

[1] Maxillofacial Surgery Department, Sant’Andrea Hospital, “Sapienza” University of Rome, Rome, Italy;Maxillofacial Surgery Department and Dentistry Department, University Hospital of Sassari, Sassari, Italy;Maxillofacial Surgery Department, Azienda Ospedaliera Universitaria Pisana of Pisa, Pisa, Italy;Maxillofacial Surgery Department, Federico II University of Naples, Naples, Italy;Maxillofacial Surgery Department, University of study of Messina, Messina, Italy

关键词: Temporal mandibular joint;    Endoscopic surgery;    Mandible fracture;    Mandibular condyle fracture;   

Others  :  1138401
DOI  :  10.1186/s12893-015-0001-9

 received in 2014-01-06, accepted in 2015-02-02,  发布年份 2015

【 摘 要 】

Background

In Literature fractures of the mandible that involve the condyle ranges from 20% to 35% and various possible surgical options are described according to the varying pathological situations. Up to the present, numerous techniques have been used for the surgical treatment of condylar fractures. In this article we are proposing the combination of two surgical techniques as therapy for extra-capsular condylar fractures with dislocation.

Methods

From June 2003 to July 2007 30 patients were treated for condylar fractures with the application of a Rigid External Fixator under endoscopic assistance. This method includes a surgical reduction of the fracture with the aid of an endoscope, performing a transcutaneous insertion of a Rigid External Fixator to stabilize the fracture.

Results

Out of the total number of patients, 28 reached an optimal result without the need for temporary immobilization of the temporal mandibular joint and pre-auricular cutaneous access, thanks to the decisive aid of the video-endoscope.

Conclusions

The endoscope allows perfect control over both the positioning of the external fixator and the surgical reduction, restoring the normal movement of the mandible with a return to full anatomical functioning of the temporo-mandibular joint. This approach avoids possible damages to the facial nerve branches. The rigid external fixation system is better than an internal one, because it is less restrictive in precise anatomical reduction, since with an REF the condylar fragment is kept in the correct anatomical position but is not obliged to maintain that exact position, and therefore it is possible to carry out all the repair mechanisms listed above. Endoscopic assistance allows a good positioning control of the REF although the endoscopy permits an optimal control of the condylemeniscal complex mobility after REF application.

【 授权许可】

   
2015 Belli et al.; licensee BioMed Central.

【 图 表 】

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