Perhaps no area of facial trauma has inspired more controversy than the management of mandibular subcondylar fractures. Fractures of the condylar region. Clinically, this equates to open treatment of condylar neck fractures or subcondylar (caudal) fractures (A). The surgeon may elect to place one or two plates. Background and objective: Mandibular fractures are the most frequent and sub condylar region is a common site of fracture. Proper.
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Rigid internal fixation of ftacture condyle fracture manidbular mini-plate on the neck of the condyle. Simple fractures are usually treated with closed reduction and indirect skeletal fixation, more commonly referred to as maxillo-mandibular fixation MMF. Except in avulsive frcture injuries, or those where there might be airway compromise, a several day delay in the treatment of mandible fractures seems to have little impact on the outcome or complication rates.
Authors using the endoscopic method to treat subcondylar fractures believe that a single intraoral incision would be sufficient to reduce a laterally displaced condyle. Despite this knowledge, and much debating, authors are still unable to agree on an absolute treatment plan for management of condylar fractures.
Wound closure is performed in layers after checking mandibular mobility and dental occlusion.
Mandibular fracture – Wikipedia
The facial bones can be visualized as slices through the skeletal in either the axialcoronal or sagittal planes. Arteriovenous fistula after mandibular condylar fracture. The dental occlusion can give orientation about frafture fracture location. Traumaosteonecrosistumors .
Contemporary oral and maxillofacial surgery 5th ed. Fractures of the facial skeleton. Finally, vascular injury can result with particular attention to the internal carotid and jugular from high velocity injuries or severely displaced mandible fractures.
Since the surgical techniques and technology, as well as the indications, continue to develop, there are few data in the literature regarding the outcomes of endoscopic fracture treatment.
Upon conclusion of the gathered information, the authors suggest 4—6 weeks of MMF in the subcondylar fractures in which the TMJ capsule is not involved. Cervical fracture Jefferson fracture Hangman’s fracture Flexion teardrop fracture Clay-shoveler fracture Burst fracture Compression fracture Chance fracture Holdsworth fracture. For fractures that occur in the non-tooth bearing area condyle, ramus, and sometimes the angle an open bite is an important clinical feature since little else, other than fracturee, may be apparent.
Annals of Plastic Surgery. In all of the situations, healing will be delayed and sometimes, resection is the only alternative to treatment.
Considerations in Subcondylar Fracture Management
Fractures of the condylar process unilateral or bilateral can occur in isolation. Uber frakturen und luxationsfrakturen des kieferkopfchens und ihre operative behandlung. It remains uncertain whether plate fixation in condylar neck fractures is rigid enough to dispense with MMF and whether fixation techniques are strong enough to withstand functional loads encountered during the period of bone healing [ 1011 ].
July 12,English editing: With a unilateral condylar process fracture and subsequent reduction of height in the ramus region, the clinician will see an ipsilateral premature occlusion and contralateral open bite.
The condylar area has a great clinical value due to its important components. D The postoperative scar is cosmetically mandibulad. While it is against surgical dicta to consider treatment of traumatic injuries through small incisions and limited access, the application of minimally invasive surgery to facial fracture repair has become widespread.
Mandibular Subcondylar Fractures: A Review on Treatment Strategies
After the skin incision, the subcutaneous dissection allows for the extension of the surgical wound to the level of the fracture. Supplemental maxillomandibular fixation with miniplate osteosynthesis-required or not?
Other fractures of the body, are classified as open or closed. Therefore, the double miniplate fixation technique via mini-retromandibular incision was used in order to make the most stable fixation when performing subcondylar fracture surgery.
Since the introduction of internal fixation appliances, open reduction of condylar fractures is becoming more popular.
When the mouth is opened, there may be deviation of the mandible towards the fractured side. Find articles by Dong Hee Kang. Get free access to newly published articles Create a personal account or sign in to: Open in a separate window.
Note that the teeth to the left of the fracture do not touch. This method is also swifter in comparison to other extraoral techniques A Systematic Review of the Subcondhlar. Journal Canadian Dental Association.
This will result in an ipsilateral premature contact of the teeth. When a fracture occurs in the tooth bearing portion of the mandible, whether or not it is dentate or edentulous will affect treatment. Coronal view of the above patient shows angulation and luxation of the condylar process fracture.