Retrospective Analysis Of Two Different Fixation Methods For Intracapsular Condyle Fracture Of Mandibular

Objective: To study the clinical treatment effect of two different fixation methods for intracapsular condyle fracture of mandibular,to discuss the selection of fixation methods for intracapsular condyle fracture of mandibular,and to summarize the advantages and disadvantages of different fixation methods,so as to provide reference for the treatment of intracapsular condyle fracture of mandibular.Methods: We reviewed the patients admitted to the oral and maxillofacial surgery ward of the affiliated hospital of Youjiang medical university for nationalities from January 2016 to August 2018 for the operation of intracapsular condyle fracture of mandibular.Thirty patients met the inclusion criteria for the study,22 were male and 8 were female,and the age range was 7 to 67 years old.All patients were operated by the same chief physician.According to the surgical fixation methods adopted by the patients after injury,the patients were divided into wire group and lag screw combined wire group,including 14 cases in the wire group and16 cases in the lag screw combined wire group.The postoperative follow-up time for each patient should be no less than 6 months,and the preoperative and postoperative general data of each patient should be recorded in detail.The treatment effects of the two different fixation methods should be comprehensively evaluated from the aspects of postoperative pain,degree of opening,alignment of fracture line and complications.Results:(1)24 hours after surgery,in the wire group,9 cases(64.3%)presented mild pain after surgery,and 5 cases(35.7%)presented moderate pain without severe pain.Postoperative pain was mild in 13 patients(81.2%),moderate in 2 patients(12.5%),and severe in 1 patient(6.3%)in the lag screw combined with wire group.The rank sum test showed no significant difference(P>0.05).(2)The preoperative mouth opening degrees of the wire group and the lag screw combined with wire fixation group were(1.44±0.67)cm and(1.71 ± 0.60)cm,respectively.The t-test analysis showed that the differences were not statistically significant(P>0.05).The degree of mouth opening were(3.48 ±0.25)cm and(3.87 ± 0.36)cm 6 months after surgery,respectively.The t-test analysis showed that the difference in the operative opening degrees between the two groups was statistically significant(P<0.05).Paired t-test was used to analyze the preoperative and postoperative opening degrees of each group,and the differences were statistically significant(P<0.05).(3)Fixation in the wire group reached anatomic reduction in 7 cases(50%),and close to anatomic reduction in 7 cases(50%),and fixation in the lag screw combined with wire group reached anatomic reduction in 14 cases(87.5%),and close to anatomic reduction in 2 cases(12.5%).According to the rank-sum test analysis,the difference in fracture alignment between the wire group and the lag screw combined wire group was statistically significant(P<0.05).(4)Infection occurred in 1 patient in the wire group and 1 patient in the lag screw combined wire group.In the wire group,there were 6 cases of joint ringing,3 cases of joint ringing in the lag screw combined wire group,and 2 cases of joint tenderness in the wire group and the lag screw combined wire group respectively.There were 2 cases of facial paralysis in the wire group and 1 case in the lag screw combined with wire group,and no temporomandibular joint ankylosis or occlusion disorder was found in the two groups.There was no statistically significant difference in the incidence of postoperative complications between the two different fixation methods in the wire group and the lag screw combined with wire group by Fisher’s exact probability method with four-grid data(P>0.05).Conclusion:(1)Two different fixation methods,wire and lag screw combined with wire,have achieved good results in the surgical treatment of intracapsular condyle fracture ofmandibular.No severe temporomandibular joint disorder or joint ankylosis occurred after the surgery,and the occlusal relationship was restored to normal,and the degree of mouth opening was significantly improved.(2)The improvement of postoperative opening degree of patients with intracapsular condyle fracture of mandibular by lag screw combined with wire fixation is better than that by wire fixation.(3)The effect of lag screw combined with wire fixation on the alignment of fracture line of intracapsular condyle fracture of mandibular is better than that of wire fixation.