Evaristo Belli, Gianmauro Liberatore, Mici Elidon, Giovanni Dell’Aversana Orabona, Pasquale Piombino, Fabio Maglitto, Luciano Catalfamo and Giacomo De Riu contributed equally to this work.
An erratum to this article can be found at http://dx.doi.org/10.1186/s12893-015-0042-0.
An erratum to this article is available at http://dx.doi.org/10.1186/s12893-015-0042-0.
The authors declare that they have no competing interests.
BE and PP directed the present study. All the authors contributed to the study concept and design. MF and ME helped with article searches, review and selection. All the authors contributed to the analysis and interpretation of data and drafting of the manuscript. LGM, DAOG and PP worked as methodological advisors. All authors read and approved the final manuscript.
In Literature fractures of the mandible that involve the condyle ranges from 20% to 35% and various possible surgical options are described according to the varying pathological situations. Up to the present, numerous techniques have been used for the surgical treatment of condylar fractures. In this article we are proposing the combination of two surgical techniques as therapy for extra-capsular condylar fractures with dislocation.
From June 2003 to July 2007 30 patients were treated for condylar fractures with the application of a Rigid External Fixator under endoscopic assistance. This method includes a surgical reduction of the fracture with the aid of an endoscope, performing a transcutaneous insertion of a Rigid External Fixator to stabilize the fracture.
Out of the total number of patients, 28 reached an optimal result without the need for temporary immobilization of the temporal mandibular joint and pre-auricular cutaneous access, thanks to the decisive aid of the video-endoscope.
The endoscope allows perfect control over both the positioning of the external fixator and the surgical reduction, restoring the normal movement of the mandible with a return to full anatomical functioning of the temporo-mandibular joint. This approach avoids possible damages to the facial nerve branches. The rigid external fixation system is better than an internal one, because it is less restrictive in precise anatomical reduction, since with an REF the condylar fragment is kept in the correct anatomical position but is not obliged to maintain that exact position, and therefore it is possible to carry out all the repair mechanisms listed above. Endoscopic assistance allows a good positioning control of the REF although the endoscopy permits an optimal control of the condylemeniscal complex mobility after REF application.
De Riu G, Raffini M, Sesenna E. Terapia chirurgica delle fratture del condilo mandibolare. Riv Ita Chir Max-Fac. 1997;1:21–9.
Iannetti G, Martucci E, Chimenti C, Pelo S. Trattamento delle fratture del condilo mandibolare. Minerva Stomatol. 1984;33:165–71. PubMed
Cascone P, Valentini V. L’uso del fissatore rigido esterno nelle fratture del condilo mandibolare. Riv Ita Chir Max Fac. 1992;1:45–9.
Belli E, Matteini C, D’Andrea GC, Mazzone N. Navigator system guided endoscopic intraoral approach for remodelling of mandibular condyle in Garré syndrome. J Craniofac Surg. 2007;18:1410-1415. Erratum in: J Craniofac Surg. 2008;19:293.
Profitt WR, Vig KWL. Early fracture of the mandibular condyles; Frequent ad unsuspected cause of growth disturbance. Am J Orthod. 1980;78:1–24. CrossRef
Toscano P, Coradeschi S. Le fratture scomposte dei condili mandibolari. Tecnica chirurgica applicata. Risultati clinico morfologici alla distanza di tre anni. Riv Ita Chir Max Fac. 1995;6:25–35.
Matteini C, Belli E. An anusual case of sub-condylar bilateral fracture and bilateral posttraumatic temporomandibuilar ankylosis. Minerva Stomat. 2001;50:337–42.
Spinzia A, Patrone R, Belli E, Dell’Aversana Orabona G, Ungari C, Filiaci F, et al. Open reduction and internal fixation of extracapsular mandibular condyle fractures: a long-term clinical and radiological follow-up of 25 patients. BMC Surg. 2014;7:14–68.
Sesenna E, Raffini M, Gianni’ AB, Tullio A, Moscato G. Risultati a distanza nel trattamento funzionale delle fratture di condilo. Rivista Italiana di chirurgia Maxillo-Facciale. 1991;2:55–62.
Filiaci F, Riccardi E, Ungari C, Rinna C, Quarato D. Endoscopic approach to maxillo-facial trauma. Ann Ital Chir. 2013;29:84.
- Surgical evolution in the treatment of mandibular condyle fractures
Giovanni Dell’Aversana Orabona
Giacomo De Riu
- BioMed Central
Neu im Fachgebiet Chirurgie
Mail Icon II