title: Lateral pterygoid myotomy with reattachment to the condylar neck: an adjunct to restore function after total joint reconstruction.
abstract: OBJECTIVE
  The purpose of this study was to investigate the results of performing a lateral pterygoid myotomy with reattachment to the condylar stump to restore more normal function after total joint reconstructive surgery.
  
  
  METHODS
  Twenty-four joints were reconstructed in 14 patients with stock Christensen chrome-cobalt prostheses. Patients were separated into 2 groups. Group I consisted of 4 joints without reattached lateral pterygoid muscle (-LPM), and group II consisted of 20 joints with reattachment of the lateral pterygoid muscle to the condylar stump (+LPM). Patients were evaluated at an average of 15 months postoperatively to assess mandibular movement. Group I was compared with group II, and statistical analysis was performed through the use of the Mann-Whitney test. Patient satisfaction was evaluated by using postoperative questionnaires.
  
  
  RESULTS
  Group II had an average interincisal opening 7.3 mm greater than Group I (P <.001). Lateral movements averaged 3.86 mm in Group II versus 0.5 mm in Group I (P <.05). Protrusion was 2.83 mm greater in Group II than in Group I (P = 0.53).
  
  
  CONCLUSIONS
  The reattachment of the lateral pterygoid muscle to the condylar stump during total joint reconstructive surgery may provide the patient with greater interincisal opening, lateral excursions, and protrusive movement. The preliminary data from these small, nonrandomized groups are promising for improved function following total joint reconstruction.
authors.affiliation: University of Washington and Washington State University, Seattle, Washington 99204-4804, USA. pcollins@cet.com
authors.forename: Chad P
authors.initials: CP
authors.lastname: Collins
authors.forename: Kory J
authors.initials: KJ
authors.lastname: Wilson
authors.forename: Patrick C
authors.initials: PC
authors.lastname: Collins
mesh_terms: D019643:Arthroplasty, Replacement; D005500:Follow-Up Studies; D006801:Humans; D007595:Joint Prosthesis; D008334:Mandible / Q000503:physiopathology; D008335:Mandibular Condyle / Q000601:surgery*; D009068:Movement; D017060:Patient Satisfaction; D011626:Pterygoid Muscles / Q000601:surgery*; D016059:Range of Motion, Articular / Q000502:physiology; D012092:Replantation; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013704:Temporomandibular Joint / Q000503:physiopathology / Q000601:surgery*