Open reduction and internal fixation of extracapsular mandibular condyle fractures: a long-term clinical and radiological follow-up of 25 patients
Identifieur interne : 001869 ( Main/Exploration ); précédent : 001868; suivant : 001870Open reduction and internal fixation of extracapsular mandibular condyle fractures: a long-term clinical and radiological follow-up of 25 patients
Auteurs : Alessia Spinzia [Italie] ; Renato Patrone [Italie] ; Evaristo Belli [Italie] ; Giovanni Dell Versana Orabona [Italie] ; Claudio Ungari [Italie] ; Fabio Filiaci [Italie] ; Alessandro Agrillo [Italie] ; Giacomo De Riu [Italie] ; Silvio Mario Meloni [Italie] ; Gianmauro Liberatore [Italie] ; Pasquale Piombino [Italie]Source :
- BMC Surgery [ 1471-2482 ] ; 2014.
Abstract
During the last 2 decades, many studies on the treatment of mandibular condyle fracture have been published. The incidence of mandibular condyle fractures is variable, ranging from 17.5% to 52% of all mandibular fractures. This retrospective study evaluated the long-term clinical and radiological outcomes after surgical treatment of 25 patients with a total of 26 extracapsular condyle fractures.
We used 2 types of surgical approaches, the retromandibular retroparotid or preauricular approach. Three kinds of rigid internal fixation plates were used—single plate, double plate, and trapezoidal plate. The following post-operative clinical parameters were evaluated: dental occlusion, facial nerve functionality, skin scarring, and temporomandibular joint functionality. All patients underwent post-operative orthopanoramic radiography and computed tomography. The patients were also monitored for complications such as Frey’s syndrome, infection, salivary fistula, plate fracture, and permanent paralysis of the facial nerve; the patient’s satisfaction was also recorded.
Of the 25 patients, 80% showed occlusion recovery, 88% had no facial nerve injury, and 88% presented good surgical skin scarring. The patients showed early complete recovery of temporomandibular joint functionality and 72% of them were found to be asymptomatic. The postoperative radiographs of all patients indicated good recovery of the anatomical condylar region, and 80% of them had no postoperative complications. The average degree of patient satisfaction was 8.32 out of 10. Our results confirm that the technique of open reduction and internal fixation in association with postoperative functional rehabilitation therapy should be considered for treating patients with extracapsular condylar fractures.
The topic of condylar injury has generated more discussion and controversy than any other topic in the field of maxillofacial trauma. We confirm that open reduction and internal fixation is the treatment of choice for patients with neck and sub-condylar mandibular fractures.
Url:
DOI: 10.1186/1471-2482-14-68
PubMed: 25196114
PubMed Central: 4163058
Affiliations:
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last="Spinzia">Alessia Spinzia</name><affiliation wicri:level="1"><nlm:aff id="I1">Maxillo-facial Surgery Unit, IRCCS University Hospital San Martino-IST National Institute for Cancer Research, Genova, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Maxillo-facial Surgery Unit, IRCCS University Hospital San Martino-IST National Institute for Cancer Research, Genova</wicri:regionArea><wicri:noRegion>Genova</wicri:noRegion></affiliation></author><author><name sortKey="Patrone, Renato" sort="Patrone, Renato" uniqKey="Patrone R" first="Renato" last="Patrone">Renato Patrone</name><affiliation wicri:level="1"><nlm:aff id="I2">Maxillofacial Surgery Department, Federico II University of Naples, Via Pansini, 5, 80131 Naples, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Maxillofacial Surgery Department, Federico II University of Naples, Via Pansini, 5, 80131 Naples</wicri:regionArea><wicri:noRegion>80131 Naples</wicri:noRegion></affiliation></author><author><name sortKey="Belli, Evaristo" sort="Belli, Evaristo" uniqKey="Belli E" first="Evaristo" last="Belli">Evaristo Belli</name><affiliation wicri:level="3"><nlm:aff id="I3">Maxillofacial Surgery Department, Sant’Andrea Hospital, “Sapienza” University of Rome, Rome, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Maxillofacial Surgery Department, Sant’Andrea Hospital, “Sapienza” University of Rome, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Dell Versana Orabona, Giovanni" sort="Dell Versana Orabona, Giovanni" uniqKey="Dell Versana Orabona G" first="Giovanni" last="Dell Versana Orabona">Giovanni Dell Versana Orabona</name><affiliation wicri:level="1"><nlm:aff id="I2">Maxillofacial Surgery Department, Federico II University of Naples, Via Pansini, 5, 80131 Naples, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Maxillofacial Surgery Department, Federico II University of Naples, Via Pansini, 5, 80131 Naples</wicri:regionArea><wicri:noRegion>80131 Naples</wicri:noRegion></affiliation></author><author><name sortKey="Ungari, Claudio" sort="Ungari, Claudio" uniqKey="Ungari C" first="Claudio" last="Ungari">Claudio Ungari</name><affiliation wicri:level="3"><nlm:aff id="I4">Maxillofacial Surgery Department, Policlinico Umberto I of Rome, “Sapienza” University of Rome, Rome, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Maxillofacial Surgery Department, Policlinico Umberto I of Rome, “Sapienza” University of Rome, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Filiaci, Fabio" sort="Filiaci, Fabio" uniqKey="Filiaci F" first="Fabio" last="Filiaci">Fabio Filiaci</name><affiliation wicri:level="3"><nlm:aff id="I4">Maxillofacial Surgery Department, Policlinico Umberto I of Rome, “Sapienza” University of Rome, Rome, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Maxillofacial Surgery Department, Policlinico Umberto I of Rome, “Sapienza” University of Rome, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Agrillo, Alessandro" sort="Agrillo, Alessandro" uniqKey="Agrillo A" first="Alessandro" last="Agrillo">Alessandro Agrillo</name><affiliation wicri:level="3"><nlm:aff id="I4">Maxillofacial Surgery Department, Policlinico Umberto I of Rome, “Sapienza” University of Rome, Rome, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Maxillofacial Surgery Department, Policlinico Umberto I of Rome, “Sapienza” University of Rome, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="De Riu, Giacomo" sort="De Riu, Giacomo" uniqKey="De Riu G" first="Giacomo" last="De Riu">Giacomo De Riu</name><affiliation wicri:level="1"><nlm:aff id="I5">Maxillofacial Surgery Department and Dentistry Department, University Hospital of Sassari, Sassari, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Maxillofacial Surgery Department and Dentistry Department, University Hospital of Sassari, Sassari</wicri:regionArea><wicri:noRegion>Sassari</wicri:noRegion></affiliation></author><author><name sortKey="Meloni, Silvio Mario" sort="Meloni, Silvio Mario" uniqKey="Meloni S" first="Silvio Mario" last="Meloni">Silvio Mario Meloni</name><affiliation wicri:level="1"><nlm:aff id="I5">Maxillofacial Surgery Department and Dentistry Department, University Hospital of Sassari, Sassari, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Maxillofacial Surgery Department and Dentistry Department, University Hospital of Sassari, Sassari</wicri:regionArea><wicri:noRegion>Sassari</wicri:noRegion></affiliation></author><author><name sortKey="Liberatore, Gianmauro" sort="Liberatore, Gianmauro" uniqKey="Liberatore G" first="Gianmauro" last="Liberatore">Gianmauro Liberatore</name><affiliation wicri:level="3"><nlm:aff id="I6">Maxillofacial Surgery Department, Azienda Ospedaliera Universitaria Pisana of Pisa, Pisa, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Maxillofacial Surgery Department, Azienda Ospedaliera Universitaria Pisana of Pisa, Pisa</wicri:regionArea><placeName><settlement type="city">Pise</settlement><region nuts="2">Toscane</region></placeName></affiliation></author><author><name sortKey="Piombino, Pasquale" sort="Piombino, Pasquale" uniqKey="Piombino P" first="Pasquale" last="Piombino">Pasquale Piombino</name><affiliation wicri:level="1"><nlm:aff id="I2">Maxillofacial Surgery Department, Federico II University of Naples, Via Pansini, 5, 80131 Naples, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Maxillofacial Surgery Department, Federico II University of Naples, Via Pansini, 5, 80131 Naples</wicri:regionArea><wicri:noRegion>80131 Naples</wicri:noRegion></affiliation></author></analytic><series><title level="j">BMC Surgery</title><idno type="eISSN">1471-2482</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>During the last 2 decades, many studies on the treatment of mandibular condyle fracture have been published. The incidence of mandibular condyle fractures is variable, ranging from 17.5% to 52% of all mandibular fractures. This retrospective study evaluated the long-term clinical and radiological outcomes after surgical treatment of 25 patients with a total of 26 extracapsular condyle fractures.</p></sec><sec><title>Methods</title><p>We used 2 types of surgical approaches, the retromandibular retroparotid or preauricular approach. Three kinds of rigid internal fixation plates were used—single plate, double plate, and trapezoidal plate. The following post-operative clinical parameters were evaluated: dental occlusion, facial nerve functionality, skin scarring, and temporomandibular joint functionality. All patients underwent post-operative orthopanoramic radiography and computed tomography. The patients were also monitored for complications such as Frey’s syndrome, infection, salivary fistula, plate fracture, and permanent paralysis of the facial nerve; the patient’s satisfaction was also recorded.</p></sec><sec><title>Results</title><p>Of the 25 patients, 80% showed occlusion recovery, 88% had no facial nerve injury, and 88% presented good surgical skin scarring. The patients showed early complete recovery of temporomandibular joint functionality and 72% of them were found to be asymptomatic. The postoperative radiographs of all patients indicated good recovery of the anatomical condylar region, and 80% of them had no postoperative complications. The average degree of patient satisfaction was 8.32 out of 10. Our results confirm that the technique of open reduction and internal fixation in association with postoperative functional rehabilitation therapy should be considered for treating patients with extracapsular condylar fractures.</p></sec><sec><title>Conclusion</title><p>The topic of condylar injury has generated more discussion and controversy than any other topic in the field of maxillofacial trauma. We confirm that open reduction and internal fixation is the treatment of choice for patients with neck and sub-condylar mandibular fractures.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Zachariades, N" uniqKey="Zachariades N">N Zachariades</name></author><author><name sortKey="Mezitis, M" uniqKey="Mezitis M">M Mezitis</name></author><author><name sortKey="Mourouzis, C" uniqKey="Mourouzis C">C Mourouzis</name></author><author><name sortKey="Papadakis, D" uniqKey="Papadakis D">D Papadakis</name></author><author><name sortKey="Spanou, A" uniqKey="Spanou A">A Spanou</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sawazaki, R" uniqKey="Sawazaki R">R Sawazaki</name></author><author><name sortKey="Lima Junior, Sm" uniqKey="Lima Junior S">SM Lima Júnior</name></author><author><name sortKey="Asprino, L" uniqKey="Asprino L">L Asprino</name></author><author><name sortKey="Moreira, Rw" 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uniqKey="Bourezak Z">Z Bourezak</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wassmund, M" uniqKey="Wassmund M">M Wassmund</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lindahl, L" uniqKey="Lindahl L">L Lindahl</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="House, Jw" uniqKey="House J">JW House</name></author><author><name sortKey="Brackmann, De" uniqKey="Brackmann D">DE Brackmann</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Baryza, Mj" uniqKey="Baryza M">MJ Baryza</name></author><author><name sortKey="Baryza, Ga" uniqKey="Baryza G">GA Baryza</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Frey, L" uniqKey="Frey L">L Frey</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Okeson, Jp" uniqKey="Okeson J">JP Okeson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Eckelt, U" uniqKey="Eckelt U">U Eckelt</name></author><author><name sortKey="Schneider, M" uniqKey="Schneider M">M Schneider</name></author><author><name sortKey="Erasmus, F" uniqKey="Erasmus F">F Erasmus</name></author><author><name sortKey="Gerlach, Kl" uniqKey="Gerlach K">KL Gerlach</name></author><author><name sortKey="Kuhlisch, E" uniqKey="Kuhlisch E">E Kuhlisch</name></author><author><name sortKey="Loukota, R" uniqKey="Loukota R">R Loukota</name></author><author><name sortKey="Rasse, M" uniqKey="Rasse M">M Rasse</name></author><author><name sortKey="Schubert, J" uniqKey="Schubert J">J Schubert</name></author><author><name sortKey="Terheyden, H" uniqKey="Terheyden H">H Terheyden</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Troulis, Mj" uniqKey="Troulis M">MJ Troulis</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ellis, E" uniqKey="Ellis E">E Ellis</name></author><author><name sortKey="Mcfadden, D" uniqKey="Mcfadden D">D McFadden</name></author><author><name sortKey="Simon, P" uniqKey="Simon P">P Simon</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Meyer, C" uniqKey="Meyer C">C Meyer</name></author><author><name sortKey="Serhir, L" uniqKey="Serhir L">L Serhir</name></author><author><name sortKey="Boutemi, P" uniqKey="Boutemi P">P Boutemi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tominaga, K" uniqKey="Tominaga K">K Tominaga</name></author><author><name sortKey="Habu, M" uniqKey="Habu M">M Habu</name></author><author><name sortKey="Khanal, A" uniqKey="Khanal A">A Khanal</name></author><author><name sortKey="Mimori, Y" uniqKey="Mimori Y">Y Mimori</name></author><author><name sortKey="Yoshioka, I" uniqKey="Yoshioka I">I Yoshioka</name></author><author><name sortKey="Fukuda, J" uniqKey="Fukuda J">J Fukuda</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Parascandolo, S" uniqKey="Parascandolo S">S Parascandolo</name></author><author><name sortKey="Spinzia, A" uniqKey="Spinzia A">A Spinzia</name></author><author><name sortKey="Parascandolo, S" uniqKey="Parascandolo S">S Parascandolo</name></author><author><name sortKey="Piombino, P" uniqKey="Piombino P">P Piombino</name></author><author><name sortKey="Califano, L" uniqKey="Califano L">L Califano</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Leiser, Y" uniqKey="Leiser Y">Y Leiser</name></author><author><name sortKey="Peled, M" uniqKey="Peled M">M Peled</name></author><author><name sortKey="Braun, R" uniqKey="Braun R">R Braun</name></author><author><name sortKey="Abu El Naaj, I" uniqKey="Abu El Naaj I">I Abu-El Naaj</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tullio, A" uniqKey="Tullio A">A Tullio</name></author><author><name sortKey="Sesenna, E" uniqKey="Sesenna E">E Sesenna</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Italie</li></country><region><li>Latium</li><li>Toscane</li></region><settlement><li>Pise</li><li>Rome</li></settlement></list><tree><country name="Italie"><noRegion><name sortKey="Spinzia, Alessia" sort="Spinzia, Alessia" uniqKey="Spinzia A" first="Alessia" last="Spinzia">Alessia Spinzia</name></noRegion><name sortKey="Agrillo, Alessandro" sort="Agrillo, Alessandro" uniqKey="Agrillo A" first="Alessandro" last="Agrillo">Alessandro Agrillo</name><name sortKey="Belli, Evaristo" sort="Belli, Evaristo" uniqKey="Belli E" first="Evaristo" last="Belli">Evaristo Belli</name><name sortKey="De Riu, Giacomo" sort="De Riu, Giacomo" uniqKey="De Riu G" first="Giacomo" last="De Riu">Giacomo De Riu</name><name sortKey="Dell Versana Orabona, Giovanni" sort="Dell Versana Orabona, Giovanni" uniqKey="Dell Versana Orabona G" first="Giovanni" last="Dell Versana Orabona">Giovanni Dell Versana Orabona</name><name sortKey="Filiaci, Fabio" sort="Filiaci, Fabio" uniqKey="Filiaci F" first="Fabio" last="Filiaci">Fabio Filiaci</name><name sortKey="Liberatore, Gianmauro" sort="Liberatore, Gianmauro" uniqKey="Liberatore G" first="Gianmauro" last="Liberatore">Gianmauro Liberatore</name><name sortKey="Meloni, Silvio Mario" sort="Meloni, Silvio Mario" uniqKey="Meloni S" first="Silvio Mario" last="Meloni">Silvio Mario Meloni</name><name sortKey="Patrone, Renato" sort="Patrone, Renato" uniqKey="Patrone R" first="Renato" last="Patrone">Renato Patrone</name><name sortKey="Piombino, Pasquale" sort="Piombino, Pasquale" uniqKey="Piombino P" first="Pasquale" last="Piombino">Pasquale Piombino</name><name sortKey="Ungari, Claudio" sort="Ungari, Claudio" uniqKey="Ungari C" first="Claudio" last="Ungari">Claudio Ungari</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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