Does Intra-operative Navigation Improve the Anatomical Reduction of Intracapsular Condylar Fractures?

Publication date: Available online 6 August 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Chaoying Han, Dilnur Dilxat, Xiao Zhang, Hui Li, Jinlong Chen, Lei Liu

Abstract

Purpose

Accurate reduction of intracapsular condylar fractures is the key to successful reconstruction of the temporo mandibular joint and remains a challenge for oral and maxillofacial surgeons. The aim of the study is to evaluate quantitatively the effect of surgical navigation on the accuracy of reduction of intracapsular fractures.

Materials and Methods

In the prospective randomized nonblinded controlled clinical trial, patients diagnosed with intracapsular condylar fractures who were scheduled for surgical treatment were included and randomized to open treatment with or without surgical navigation. The primary predictor variable was surgical navigation. The primary outcome variable is the average distance (AD) between preoperative and postoperative computed tomography measurements. The second outcome variable is the rate of anatomic reduction. The X² test and independent samples t-test were used for statistical analyses.

Results

Twenty patients (33 sides) with intracapsular condylar fractures were enrolled and treated with open surgery (13 men, 7 women; mean age, 28.65 yr; range, 13 to 54 yr). Among them, 10 patients (16 sides) and 10 patients (17 sides) were treated, respectively, with and without surgical navigation technology. All the patients had been followed up for 1, 3, 6 and 12 months. The mean AD was 0.5235 mm in the navigation group and 1.170 mm in the control group (P < 0.001). The rate of anatomic reduction was 93.8% in the navigation group and 88.2% in the control group (P = 0.58). The results indicated that a more precise reduction was achieved in the navigation group than in the control group.

Conclusion

According to the study results, the rate of anatomic reduction increased and the ADs decreased in the navigation group compared with navigation group. Therefore, surgical navigation could increase the accuracy of reduction during the surgical treatment of intracapsular condylar fractures.

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