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Objective@#To evaluate the value of Kirschner wire internal fixation in the treatment of sagittal mandibular condylar fractures.@*.Methods @#From January 2019 to January 2020, 13 patients (19 sides) with mandibular condylar sagittal fracture treated by Kirschner wire internal fixation at the Stomatological Medical Center, Foshan Hospital of Traditional Chinese Medicine were retrospectively analyzed. After conventional surgical incision and exposure and reduction of the mandibular condyle, 2-4 Kirschner wires were used for fixation, and other maxillofacial fractures were treated simultaneously. The reduction accuracy and stability of the free mandibular condyle were evaluated by CBCT one week after the operation, and the occlusion relationship, opening degree and opening type were evaluated by clinical examination.@*Results@#All patients had good fracture alignment and no twisting, breaking or loosening of the Kirschner wire. The occlusion relationship, opening degree and opening shape recovered well after the operation.@*Conclusion@# Kirschner wire is effective in treating sagittal fractures of mandibular condyles.
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Objective@#A retrospective research was made to summarize the clinical characteristics, treatment methods, results of the adult cases with sagittal fracture of mandibular condyle (SFMC).@*Methods@#One hundred and fifty-one cases of hospitalized patients were enrolled. The age, sex, etiology, level of fracture, degree of displacement, associated facial fractures, treatment methods and results were retrospectively analyzed.@*Results@#The patient′s age ranged from 16 to 81 years old, with a median age of 38.5 years. The male to female ratio was 2.97∶1. The most involved age group was 20-29 years old [35.1% (53/151)]. Falls [53.6% (81/151)] were the most common cause. According to the classification of He (2009) and Duan (2011), the most common type of SFMC was type A [60.5% (130/215)] and the displacement type [80.9% (174/215)]. Eighty-six point zero percent (185/215) of SFMC were treated by surgery. The surgical rates of type A, B and M fractures were 91.5% (119/130), 79.6% (43/54) and 88.5% (23/26), with significant differences between the groups (P<0.05). The surgical rates of the displacement and dislocation type were 89.7% and 100%, with significant differences. The differences between the fixations of type A, type B and type M fractures were statistically significant. The follow-up results showed that, 78.7% (59/75) of patients treated with surgery had normal occlusion, no joint symptoms and no limited mandibular movement. Patients treated with conservative therapy had good occlusion and an average maximum mouth opening of 36.25 mm with malunion occurred in 5/6 of the condyles.@*Conclusions@#Under appropriate surgical indications, surgical treatment of SFMCs could achieve significantly better outcomes than conservative treatment.
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<p><b>OBJECTIVE</b>To explore the selection of temporomandibular joint (TMJ) disc reduction and fixation methods in condylar sagittal fracture surgery.</p><p><b>METHODS</b>A total of 36 patients with condylar fractures were chosen. The follow-up period was more 6 months. All 36 cases of condylar sagittal fracture were fixed with long screw. In the operation, the displaced joint disc was repositioned and fixed. The fixed method included direct suture (22 cases) and anchorage (14 cases). Clinical followups were performed before surgery and 1 month, 3 months, 6 months and 1 year after surgery. Clinicians recorded data related to the Fricton craniomandibular index (CMI) and evaluated the postoperative joint function during followup before surgery and 6 months after surgery.</p><p><b>RESULTS</b>In both groups, function of TMJ significantly improved after surgery. The CMI decreased from 0.213±0.162 and 0.273±0.154 to 0.059±0.072 and 0.064±0.068 (P<0.05), respectively. No statistical difference was observed between the two groups in palpation index (PI), dysfunction index (DI) and CMI (P>0.05) before or after surgery.</p><p><b>CONCLUSIONS</b>Both methods could effectively improve the dysfunction of the TMJ caused by trauma. The selection of joint disc reduction and fixation methods is based on the displacement and damage degree of the joint disc.</p>
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Objective:To analyze the biomechanical stress distribution on the sagittal fractured of the mandibular condyle(SFMC) fixed by double plates in 3 different ways.Methods:The fixation finite element models with double straight plates(SS),one straight and one L-form plates(SL),and double L-form plates(LL)were established.The biomechanical stresses on condyle were calculated with finite element analysis.Results:In the model of SS fixation the maximum equivalent stress (MES),maximum total displacement (MTD)and maximum total corner(MTC)of condylar stump were 525.475 MPa,0.902 2 mm and 0.260 1°;MES,MTD,and MTC on fractured free-end were 4.425 MPa,0.882 7 mm and 0.019 9°,respectively.In the model of SL fixation MES,MTD and MTC on condylar stump were 1 135 MPa,0.9367 mm and 0.126 1°;MES,MTD and MTC on fractured free-end were 2.656 MPa,0.887 1 mm and 0.016 9°,respectively.In the model of LL fixation MES,MTD and MTC on condylar stump were 2 208 MPa,0.923 8 mm and 0.172 2°;MES,MTD and MTC on fractured free-end were 14.66 8 MPa,0.876 6 mm and 0.018 1°,respectively.Conclusion:Double L plates fixation is a proper way for SFMC.
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Objective:To evaluate the technique of reduction and rigid internal fixation of sagittal maxillary fracture. Methods:15 cases of sagittal maxillary fracture were reviewed. Occlusal guide plates were prepared preoperatively by model surgery analysis in 10 cases; Le Fort ? osteotomy and down-fracture were done in 8 cases; Pterygomaxillary junctions were also separated in the other cases. Internal fixation was applied along the anterior maxillary surface by using microplates in all 15 cases. Results:Anatomically reduction was achieved in all cases; Occlusion of 14 cases was corrected except one case of fracture re-displaced. Conclusion:Orthognathic technique is effective treatment of sagittal maxillary fracture; One microplate applied along anterior maxillary surface may be not enough to ensure the fixation of sagittal maxillary fracture.
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Sagittal fracture of the cervical spine is a rara injury and little information exists as to its incidence, the mechanism involved, or the result of treatment. Fracture of the cervical vertebral body in the sagittal plane is splitted it into almost equal right and left halves. Computed tomography has made it possible to analyze the vertebral fracture more thoroughly. Sagittal fracture of the cervical spine is reported with brief review of literature.