Axial 'anchor' screw (lag screw with biconcave washer) or 'slanted-screw' plate for osteosynthesis of fractures of the mandibular condylar process.
Almost a quarter of all mandibular fractures are located in the condylar neck region and generally lead to disturbances of occlusion. Because they still possess active growth centres, children and adolescents can take advantage of the joint's remodelling capacity following conservative treatment of these fractures. Fractures with displacement of the condylar head in adults can interfere with function if they are not surgically reduced (Krenkel and Strobl, 1989). In addition, a compensatory overloading of the non-fractured side, which originally goes unnoticed, can bring about disc pathology and chronic pain years later. For this reason, a surgical technique was developed for the management of mandibular condylar neck fractures. A new axial/oblique-axial lag screw (anchor screw) with biconcave washers (anchor washer) makes it possible to carry out standardized osteosynthesis in the region of the thin mandibular condyle neck. Functional exercises can be initiated immediately after the operation. There are three operative procedures using an extraoral approach (1-3) and two using an intraoral approach (4-5), depending on the type and severity of the fracture: 1. Direct anchor screw osteosynthesis with closed gliding hole. 2. Indirect anchor screw osteosynthesis with open gliding groove and safety plates. 3. Osteosynthesis with a 'slanted-screw' plate for longer oblique fractures. 4. Intraoral anchor screw method. 5. Intraoral anchor screw method with intraoral 'slanted-screw' plate. The functional long-term results of conservatively and surgically treated mandibular condylar neck fractures were objectively documented by means of mechanical and electronic axiography. The functional long-term results of the condylar neck fractures treated surgically were significantly better than those treated conservatively.(ABSTRACT TRUNCATED AT 250 WORDS)
Krenkel
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Department of Maxillofacial Surgery-LKA Salzburg, Austria.
D001860:Bone Plates; D001863:Bone Screws; D004867:Equipment Design; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D004204:Joint Dislocations / Q000473:pathology / Q000601:surgery; D008297:Male; D008334:Mandible / Q000473:pathology / Q000503:physiopathology; D008335:Mandibular Condyle / Q000293:injuries* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008337:Mandibular Fractures / Q000145:classification / Q000473:pathology / Q000601:surgery*; D009068:Movement; D013499:Surface Properties; D013704:Temporomandibular Joint / Q000503:physiopathology