Does open reduction internal fixation along with articular disc anatomical reduction and rigid anchorage manifested promising prospect in the treatment of intracapsular fractures?

Publication date: Available online 28 December 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Bo-Lei Cai, Rong Ren, Hong-Bo Yu, Peng-Chao Liu, Steve GF. Shen, Jun Shi
PurposeAs growing attention was paid to soft tissue reduction in the treatment of intracapsular condylar fractures (ICFs), a modified opening reduction technique was proposed and the functional and radiographic outcomes were evaluated in this study.MethodsA retrospective case series study of all types ICFs patients, which were treated with open reduction internal fixation (ORIF) along with articular disc anatomical reduction and rigid anchorage, was presented in this study. Inclusion and exclusion criteria were strictly executed. Preoperative and postoperative clinical examinations, such as malocclusion, maximum incisor opening (MIO), laterotrusion and temporomandibular disorder symptoms were recorded and analyzed. Computed tomography (CT) and magnetic resonance imaging (MRI) were taken to assess articular position, condyle morphology and position.ResultsThirty-four ICFs patients with 47 sides ICFs were treated with our modified ORIF technique. At 6 months of follow-up, no malocclusion was found and the MIO significantly expanded to 3. 56 ± 0.13cm. Only 4 (12%) patients had TMJ discomfort with mouth opening. Interestingly, for unilateral type B ICFs patients, laterotrusion distance to ORIF sides was significantly larger than to non-ORIF sides. Postoperative CT and MRIs showed that all the fragments were properly reduced and the condyles were in the normal position, postoperative anterior disc displacement happened to 4 sides and condyle morphological abnormalities (slight surface roughening and articular cartilage absorption) happened to 3 (6.4%) sides.ConclusionsOur modified ORIF technique, which achieved inspiring outcomes on the treatment of all types of ICFs, manifested promising prospect in the treatment of ICFs.



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