Lag screw osteosynthesis of fractures of the mandibular condyle: potential benefit of preoperative planning using multiplanar CT reconstruction.
OBJECTIVE
The purpose of the study was to develop a method of multiplanar CT reconstruction in fractures of the mandibular condyle in order to evaluate the feasibility of lag screw osteosynthesis.


METHODS
Angulated axial and sagittal images of the mandibular ramus were calculated using collected CT data. In 183 mandibular rami the optimal position of the screw axis was determined retrospectively. The thickness of the covering bone as well as the degree of screw exposure were measured.


RESULTS
Application of the method led to medial (28.4% of cases) or lateral (3.8% of cases) correction of the usual screw axis. In 1.6% of cases an extraosseous position of screws could not be avoided by this correction.


CONCLUSIONS
Evaluation of the feasibility of lag screw osteosynthesis by this method is possible. Medial or lateral change of the axis ensures the optimal intraosseous screw position. Intraosseous screw placement is almost always possible.
Schneider
Alexander
A
Department of Oral and Maxillofacial Surgery, University of Technology Dresden, Dresden, Germany. mkg-Chirurgie@uniklinikum-dresden.de
Schulze
Jana
J
Eckelt
Uwe
U
Laniado
Michael
M
D001863:Bone Screws; D004867:Equipment Design; D005240:Feasibility Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008334:Mandible / Q000000981:diagnostic imaging; D008335:Mandibular Condyle / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D008337:Mandibular Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D010347:Patient Care Planning; D012189:Retrospective Studies; D036542:Tomography, Spiral Computed; D014057:Tomography, X-Ray Computed / Q000379:methods*