OPEN REDUCTION OF MANDIBULAR CONDYLE NECK FRACTURES: CASE REPORT AND LITERATURE REVIEW-Mandibular Kondil Boynu Kırıklarında Açık Redüksiyon: Olgu Raporu ve Kaynak Taraması

Sabri Cemil İŞLER, Erol CANSIZ, Emine AKBAŞ, Zerrin ÇEBİ
1.228 515

Abstract


ABSTRACT
Since cases of mandibular condyle fractures may result in difficulty of recovery of functional and aesthetic disorders, their immobilization and reduction are very important. It may cause long-term complications as well as limited mandibular movement, pain, malocclusion, pathological changes in the TMJ, osteonecrozis, facial asymmetry, ankylosis, functional and growth disorders. Appropriate
treatment must enable the reconstruction of undamaged functional and natural form of mandibular condyle. For this purpose, an exact diagnosis, correct reduction and rigid fixation are required. In all types of condylar fractures, the presence of teeth, fracture level, the adaptation of the patient, masticatory
system of the patient, as well as the presence of occlusal dysfunction and mandible deviation should be taken into consideration and then the appropriate treatment should be decided. In the past, mandibular condyle fractures were generally treated conservatively by intermaxillary fixation; however,
recently, rigid internal fixation by open reduction became popular. Nevertheless, the treatment of mandibular condyle fractures is still controversial.
In this case report, the treatment of a mandibular condyle neck fracture by open reduction is presented and a literature review about the treatment protocol of condylar fractures is performed.

Keywords: Open reduction, internal fixation, mandibular condyle neck fractures

ÖZ
Mandibular kondil fraktürleri fonksiyonun ve estetiğin geri kazanımının zor olduğu bozukluklara yol açabileceğinden immobilizasyonu ve redüksiyonu oldukça önemlidir. Özellikle mandibulanın hareketlerinde kısıtlılık, ağrı, maloklüzyon, TME’de patolojik değişiklikler, osteonekrozis, fasial asimetri,
ankiloz, fonksiyon ve büyüme bozuklukları gibi uzun dönem komplikasyonlara neden olabilirler. Uygun olan tedavi için, mandibular kondilin zarar görmemiş fonksiyon ve şeklinin rekonstrüksiyonu sağlanmalıdır. Bunun için; kesin diagnoz, doğru redüksiyon ve rijit fiksasyon gerekir. Kondil fraktürlerinin her tipinde dişlerin varlığı, fraktürün seviyesi, hasta adaptasyonu, hastanın çiğneme sistemi ve eğer varsa oklüzal fonksiyon bozuklukları ile mandibula deviasyonu değerlendirilerek tedavi metodu
seçilmelidir. Geçmişte mandibular kondil fraktürleri genellikle konservatif olarak tedavi edilseler de, son yıllarda rijit internal fiksasyon ve açık redüksiyonla tedavi daha yaygın hale gelmiştir. Ancak mandibular kondil kırıklarının tedavisi günümüzde halen tartışmalı durumdadır. Bu vaka raporunda açık redüksiyonla tedavi edilen mandibular kondil boynu kırığı olgusu anlatılmış ve kondil kırıklarının tedavisiyle ilgili literatür taraması yapılmıştır.

Anahtar kelimeler: Açık redüksiyon, internal fiksasyon, mandibular kondil boynu kırıkları


Keywords


Open reduction, internal fixation, mandibular condyle neck fractures

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DOI: http://dx.doi.org/10.17096/jiufd.94711

References


Turvey TA. Midfacial fractures: a retrospective analysis of 593 cases. J Oral Surg 1977;35(11):887-91.

Manisali M, Amin M, Aghabeigi B, Newman L. Retromandibular approach to the mandibular condyle: a clinical and cadaveric study. Int J Oral Maxillofacial Surg 2003;32(3):253-6.

Sugiura T, Yamamoto K, Murakomi K, Sugimura M. A comparative evaluation of osteosynthesis with lag screws, miniplates or Kirschner wires for mandibular condylar process fractures. J Oral Maxillofac Surg 2001;59(10):1161-8.

Choi KY, Yang JD, Chung HY, Cho BC. Current concepts in the mandibular condyle fracture management part I : overview of condylar fracture. Arch Plast Surg 2012;39(4):291-300.

Tasanen A, Lamberg MA. Transosseous wiring in the treatment of condylar fractures of the mandible. J Maxillofac Surg 1976;4(4):200-6.

Schön R, Roveda SI, Carter B. Mandibular fractures in Townsville, Australia: incidence, aetiology and treatment using the 0 AO/ASIF miniplate system. Br J Oral Maxillofac Surg 2001;39(2):145-8.

Brandt MT, Haug RH. Open versus closed reduction of adult mandibular condyle fractures: a review of the literature regarding the evolution of current thoughts on management. J Oral Maxillofac Surg 2003;61(11):1324-32.

Lindahl L. Condylar fractures of the mandible. I. Classification and relation to age, occlusion, and concomitant injuries of teeth and teeth-supporting structures, and fractures of the mandibular body. Int J Oral Surg 1977;6(1):12-21[In: Zachariades N, Mezitis M, Mourouzis C, Papadakis D, Spanou A. Fracturers of the mandibular condyle: a review 466 cases. Literature review, reflections on treatment proposals. J Cranio Maxillofac surg 2006;34(7):421-32.]

Loh FC, Tan KB, Tan KK. Auditory canal haemorrhage following mandibular condylar fracture. Br J Oral Maxillofac Surg 1991;29(1):12–3.

Choi KY, Yang JD, Chung HY, Cho BC. Current concepts in the mandibular condyle fracture management part II: open reduction versus closed reduction. Arch Plast Surg 2012;39(4):301-8. doi: 10.5999/ aps.2012.39.4.301. Epub 2012 Jul 13.

Ellis E 3rd, Plamieri C, Throckmorton G. Further displacement of condylar process fractures after closed treatment. J Oral Maxillofac Surgery 1999;57(11):1307-16.

Ellis E 3rd, Throckmorton GS, Palmieri C. Open treatment of condylar process fractures: assessment of adequacy of repositioning and maintenance of stability. J Oral Maxillofac Surg 2000;58:27-34.

Ellis E 3 rd, Simon P, Throckmorton Gs. Occlusal results after open or closed treatment of fractures of the mandibular condylar process. J Oral Maxillofac Surg 2000;58:260-8.

Marker P, Nielsen A, Bastian HL. Fractures of the mandibular condyle. Part 2: results of treatment of 348 patients. Br J Oral Maxillofac Surg 2000;38(5):422-6.

Ellis E,Throckmorton GS.Treatment of mandibular condylar process fractures: biological considerations. J Oral Maxillofac Surg 2005;63(1):115-34.

Assael LA. Open versus closed reduction of adult mandibular condyle fractures: an alternative interpretation of the evidence. J Oral Maxillofac Surg 2003;61(11):1333-9.

Haug RH, Assael LA. Outcomes of open versus closed treatment of mandibular subcondylar fractures. J Oral Maxillofac Surg 2001;59(4):370-5.

Wagner A, Krach W, Schicho K, Undt G, Ploder O, Ewers R. A-3-dimensional finite-element analysis investigating the biomechanical behavior of the mandible and plate osteosynthesis in cases of fractures of the condylar process. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;94(6):678-86.

Anastassov GE, Lee H, Schneider R. Arthroscopic reduction of a high condylar process fracture:a case report. J Oral Maxillofac Surg 2000;58(9):1048-51.

Zide MF, Kent JN. Indications for open reduction of mandibular condyle fractures. J Oral Maxillofac Surg 1983;41(2):8998 [In:Spinzia A, Patrone R, Belli E, Dell’Aversana Orabona G, Ungari C, Filiaci F, Agrillo A, De Riu G, Meloni SM, Liberatore G, Piombino P. Open reduction and internal fixation of extracapsular mandibular condyle fractures: a long-term clinical and radiological follow-up of 25 patients. BMC Surg 2014;14(1):68.]

Worsaae N, Thorn JJ. Surgical versus nonsurgical treatment of unilateral dislocated low subcondylar fractures: a clinical study of 52 cases. J Oral Maxillofac Surg 1994;52(4):353-60; discussion 360-1.

Ellis E 3rd, Palmieri C, Throckmorton G. Further displacement of condylar process fractures after closed treatment. J Oral Maxillofac Surg 1999;57(11):1307-16.

Ellis E 3rd, Simon P, Throckmorton GS. Occlusal results after open or closed treatment of fractures of the mandibular condylar process. J Oral Maxillofac Surg 2000;58(3):260-8.

Corresponding Author : Erol CANSIZ Department of Maxillofacial Surgery Faculty of Dentistry Istanbul University 34093, Capa, Istanbul, Turkey. Phone: +90 212 414 20 20 - 30373 e– mail:erolca@yahoo.com




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