[Treatment of condylar fracture by external pterygoid muscle-condyle anatomical reduction and internal rigid fixation with mini titanium plates].

PURPOSE

To investigate the surgical indications, procedures and treatment outcomes of condylar fracture by external pterygoid muscle-condyle anatomical reduction and internal rigid fixation with mini titanium plates.

METHODS

Patients with dislocation of the condylar head, fracture of the condylar neck and subcondylar neck (the degree of displacement greater than 30 to 45) and decreased vertical height of the ramus (greater than 4 to 5mm) were included in the study. Modified aural-temporal stick-shaped incision or retromandibular approach was adopted in 23 cases with 28 condylar fractures. The fractures were treated by external pterygoid muscle-condyle anatomical reduction and internal rigid fixation with mini tension band titanium plates. All the patients were re-examined and evaluated 3 to 6 months after surgery in respects of facial symmetry, mouth opening, types of mouth opening, occlusion and mastication.

RESULTS

All the patients had symmetrical face, mouth opening increased from 26.7+/-7.2 (before surgery) to 38.4+/-5.6 (3 months after surgery) and 37.2+/-4.5 mm(6 months after surgery). 2 patients with postoperative malocclusion had intermaxillary distraction for 1 week and their occlusion returned to normal. Radiographic check-up showed the condyle and titanium plates without displacement. No absorption was noted on the condylar surface. The patients had normal mastication. 2 patients with temporal facial paralysis recovered 3 months after conservative therapy.

CONCLUSION

Treatment of condylar fracture by external pterygoid muscle-condyle anatomical reduction and internal rigid fixation with mini titanium plates in selected patients is an effective procedure for recovery of anatomical positions and masticatory function. Supported by Research Fund from Science and Technology Bureau of Jining city.