Retrieval of the displaced condylar fragment with a screw: simple method of reduction and stabilisation of high and intracapsular condylar fractures

Abstract We acknowledge the difficulties that arise when attempting to reduce and stabilise some condylar fractures, particularly those that are high or intracapsular. This paper highlights retrieval of the proximal fragment with a screw, and its benefit for reduction and stabilisation of the fractu...

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Bibliographic Details
Published in:British journal of oral & maxillofacial surgery 2011-01, Vol.49 (1), p.58-61
Main Authors: Jones, Simon D, Sugar, Adrian W, Mommaerts, Maurice Y
Format: Article
Language:English
Subjects:
Adolescent
Adult
Biological and medical sciences
Bone Plates
Bone Screws
Condylar fractures
Dental Occlusion
Dentistry
Follow-Up Studies
Fracture Fixation, Internal - instrumentation
Fracture Fixation, Internal - methods
Humans
Intracapsular
Joint Capsule - injuries
Joint Dislocations - surgery
Mandibular Condyle - injuries
Mandibular Condyle - surgery
Mandibular Fractures - surgery
Medical sciences
Middle Aged
Otorhinolaryngology. Stomatology
Range of Motion, Articular - physiology
Reduction
Screw retrieval
Stabilisation
Surgery
Temporomandibular Joint - injuries
Young Adult
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Summary:Abstract We acknowledge the difficulties that arise when attempting to reduce and stabilise some condylar fractures, particularly those that are high or intracapsular. This paper highlights retrieval of the proximal fragment with a screw, and its benefit for reduction and stabilisation of the fractured condylar head before fixation. Eight patients with condylar fractures were treated at two centres, Morriston Hospital, Swansea, South Wales, and the General Hospital St. Jan, Brugge, Belgium between 1998 and 2007. The proximal fragment was retrieved by insertion of a screw in all cases. Three patients had unilateral, and five had bilateral high or intracapsular fractures. In all cases postoperative scans showed excellent anatomical repositioning and fixation of the condylar fragments. Postoperative follow-up showed good, stable occlusion, excellent mouth opening, and no facial nerve weakness even for a temporary period. Once the screw is in position the operator can gain precise control of the reduction, and the ease of manipulation reduces operating time considerably. The technique provides an excellent solution to the difficult task of reduction and stabilisation of the displaced fragment in condylar fractures, particularly in high fractures, and can be extended to other areas of maxillofacial trauma and corrective bone surgery.
ISSN:0266-4356
1532-1940
DOI:10.1016/j.bjoms.2010.02.006