ABSTRACT
The aim of this study was to investigate whether life-like fractures of human cadaveric mandibles with a focus on the condylar process and the intact soft tissue envelope could be simulated. A total of nine fresh-frozen human head specimens were fractured in a custom-made drop-test bench. This reproducible method is based on a weight falling from a defined height onto the fixed specimens, simulating a direct blow to the symphysis of the mandible. All the fractures were analyzed by fluoroscopy and CT-scans. In all the specimens that were included in this study, several typical lesions could be created, resulting in a total of 27 mandible fractures. Seven condylar head fractures with intracapsular fracture patterns, three high, two low and five subcondylar fractures as well as different corpus fractures occurred. Human cadaveric mandibles as part of a complete head specimen with intact soft tissue can be successfully fractured by means of a drop-test bench setup. The amount of load and the exact angle at which the load is applied seem to be of high relevance. Such fractured specimens can be implemented in surgical education courses to teach and improve osteosynthetic techniques.
Subject(s)
Mandibular Fractures , Surgery, Oral , Fracture Fixation, Internal , Humans , Mandible/surgery , Mandibular Condyle , Mandibular Fractures/surgery , Tomography, X-Ray ComputedABSTRACT
Fractures of the mandibular condyle lead to displacement of the condyle and loss of the height of the ramus. A retromandibular approach is the most commonly used for open reduction and internal fixation (ORIF) of such fractures. We aimed to compare the complications associated with a retromandibular transparotid approach with a retromandibular transmasseteric anterior parotid (TMAP) approach for their management. Thirty patients were randomly selected into two groups (15 in each): Group A comprised the retromandibular transparotid approach and Group B the retromandibular TMAP. The variables evaluated were: operating time, facial nerve injury, occurrence of Frey syndrome, and sialocoele at one week, four weeks, three months, and six months. The mean (SD) age in group A and B was 33.93 (17.97) years and 33.53 (16.15) years, respectively, and there were 28 men and two women. Mean (SD) exposure time in the transparotid approach was 26.93 (5.19) minutes and 25.4 (8.35) minutes in the TMAP approach. The incidence of facial nerve injury was 2/15 patients in the transparotid group and 3/15 in the TMAP group, all of which resolved within six months. The incidence of sialocoele was 2/15 in the transparotid group. The results did not show any significant difference in complications between the two approaches, but the retromandibular transparotid approach provided straight-line access in fractures of the condylar neck, with fewer incidences of nerve injury. The anterior parotid approach, on the other hand, provided easier access for fractures that were medially dislocated or of the condylar base but had an increased incidence of facial nerve injuries.
Subject(s)
Facial Nerve Injuries , Mandibular Condyle/injuries , Mandibular Fractures , Adult , Facial Nerve Injuries/epidemiology , Facial Nerve Injuries/prevention & control , Female , Fracture Fixation, Internal/methods , Humans , Male , Mandibular Condyle/surgery , Mandibular Fractures/surgery , Prospective Studies , Treatment OutcomeABSTRACT
0.05)respectively.Conclusions:Treatment of condylar process fracture should be based on the type of the fracture.
