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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Surgery 1/2015

Surgical evolution in the treatment of mandibular condyle fractures

Zeitschrift:
BMC Surgery > Ausgabe 1/2015
Autoren:
Evaristo Belli, Gianmauro Liberatore, Mici Elidon, Giovanni Dell’Aversana Orabona, Pasquale Piombino, Fabio Maglitto, Luciano Catalfamo, Giacomo De Riu
Wichtige Hinweise
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.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

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.

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.
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