ABSTRACT
Objective To develop a suitable forcep for reduction and internal fixation of sagittal fracture of mandibular condyle (SFMC) and evaluate its role in clinical practice.Methods Twenty patients with SFMC diagnosed by three-dimensional CT undergone open surgery were divided into experimental group and control group with 10 patients per group,according to the random number table.Patients in experimental group were reduced and fixed using the new reduction forcep,while in control group by the classical vascular clamp and nerve retractor.Operation time,three-dimensional CT before operation and 2 weeks after operation,and occlusion,maximum mouth opening (MMO),visual analogue scale (VAS),joint clicking as well as noise before operation and 1 and 6 months after operation were recorded.Results Operation time was obviously lower in experimental group than in control group [(0.90 ± O.11)hours vs (1.34 ±0.10)hours,t =-10.8,P ＜0.01].MMO in experimental group revealed significant improvements compared to control group at postoperative 1 month [(32.6 ± 1.6) mm vs (29.7 ±1.6)mm,t =-10.1,P＜0.01] and at postoperative 6 months [(34.3 ± 1.2)mm vs (33.3 ± 1.1)mm,t =3.4,P ＜0.01].VAS between experimental group and control group also differed significantly at postoperative 1 month [(3.6 ± 0.7) mm vs (5.1 ± 0.7) mm,t =-12.5,P ＜ 0.01] and at 6 months [(3.5±0.9) points vs (4.8±0.6) points,t=-3.3,P＜0.01].Conclusion The new reduction forcep can shorten operative time and improve mouth opening and pai for SFMC.
ABSTRACT
Objective To analyze the separation and displacement of bone fragments in sagittal fracture of the mandibular condyle (SFMC),understand the motion type and guide clinical treatment and development of related surgical instruments.Methods Forty-five patients (52 sides) with SFMC treated between October 2008 and October 2012 were enrolled; 32 patients (36 sides) were males and 13 patients (16 sides) were females.According to the Neff classification,there were 20 sides with type A,28 sides type B and 4 sides type M.All the patients underwent CT scan and were classified based on measurements of distance and angle of displaced bone fragments.Results Patients were categorized into type Ⅰ on 20 sides (type Ⅰ A on 14 sides and type Ⅰ B on 6 sides),type Ⅱ on 27 sides (type Ⅱ A on 11 sides and type ⅡB on 16 sides),type ⅢB in 1 side and type Ⅳ in4 sides.Mean displacement of bone fragments was 12 mm (range,4-16 mm) ; mean deviation angle was 34°(range,11°-43°) ; mean descending distance was 13 mm (range,6-18 mm).Conclusion CT analysis results show that,mast bone fragments in SFMC move slightly.