The Clinical Research Of The Mandibular Condylar Fractures

Objective:Study kinds of treatment methods of mandibular condyle fractures, provide a theoretical basis and clinical guidance on mandibular condyle fracture therapy.Methods:124(150side) patients with mandibular condyle fracture lived in the second hospital of Tianjin medical university was involved in the study. A systemic review was presented with epidemiology, fracture characteristic, treatment methods, treatment effectiveness and complication.Results:Traffic accidents were the main cause of condylar fractures, which occurred mainly in young adult males.site. Parasymphysis-condylar combined fracture was most in combination injury, the best radiologic examination on condylar fracture diagnosis was crown CT. Condylar base was the main fracture site(52%). B fracture was most in intracapsular fractures(51.4%). There were10sides with the conservative treatment,140sides with the surgical treatment, preauricular operative approach was mainly used for intracapsular fracture. Retromandibular, submandibular, and transparotid approach was mainly used for condylar neck and condylar neck and condylar base fracture. There was A fractures with conservative treatment,B fracture with lateral screws and plate, M fracture with lateral screws and condylar extirpation in35intracapsular fractures. We chose miniplate in115extracapsular fractures except2which used conservative treatment. There was significant difference in mouth openning(t<0.01). The occlusion was good in1week except3bilateral intracapsular condylar fracture combine with symphysis fracture.19patients deviated on opening most with intracapsular fracture (37%). Facial palsy was most with pretragus incision(25%), no significant difference between retromandibular transparotid and submandibular approach. There were2patients with deviated opening and uninvolved joint pain,3patients condylar displacement, no ankylosis,no condylar apparent absorption necrosis in6months.Conclutions:There was kinds of treatment on mandibular condyle fractures, but operation was using more and more with good fixed methods, surgical instruments and material development. Open reduction and internal fixation was using on condylar neck and condylar base fracture, the therapy of intracapsular fracture was based on the displacement, age and concomitant fractures. Recovery of the temporomandibular joint anatomy and function with less damage and the most safe and simple method was our surgeons should follow.