Delayed open reduction and single screw internal fixation as a treatment option in cases of failed non-surgical treatment of bilateral condylar head fractures with fragmentation

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• 作者：Bin Zhang ^{posseidonz@163.com" class="auth_mail" title="E-mail the corresponding author} ; Mingliang Yang ; ^{aresyml@163.com" class="auth_mail" title="E-mail the corresponding author} ; Qing Zhou ^{apollozq@163.com" class="auth_mail" title="E-mail the corresponding author} ; Qiang Liu ^{liu66k@126.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Open reduction ; Internal fixation ; Delayed bilateral condylar head fracture ; Fragmentation ; Single screw
• 刊名：Journal of Cranio-Maxillofacial Surgery
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：44
• 期：10
• 页码：1655-1661
• 全文大小：2410 K

文摘

To share our experience in the open reduction and single screw internal fixation of delayed bilateral condylar head fractures with fragmentation and evaluate its feasibility and outcomes.

Patients and methods

The study involved 6 males and 1 female. All patients had multiple injuries at different body sites and failed non-surgical treatment of bilateral condylar head fractures. The mean period between the injury and the operation was 5.7 (4–8) weeks. According to the preoperative computer-aided design, and the clinical manifestations, the fracture fragments were reduced and fixed with a single screw. A helical CT scan was requested postoperatively to check the reduction of the fragments and the location of the screws. Mean follow-up duration was 9.7 (8–14) months.

Result

The malocclusion was corrected after operation. The intraoperative passive mouth opening was 3.93 ± 0.19 cm. The mouth opening was 3.43 ± 0.35 cm in 3 months follow-up, and more than 3 transverse fingers at the last follow up. No one had a progressive limitation of the mouth opening in 8–14 months of follow up.

Conclusions

The strategy of open reduction and single screw internal fixation of bilateral condylar head fracture with fragmentation of mandible is feasible and effective. It is a treatment option in the rare delayed cases of failed non-surgical treatment.