title: Minimally invasive fracture treatment with cannulated lag screws in intracapsular fractures of the condyle.
abstract: OBJECTIVE
  We examined the use of cannulated lag screw osteosynthesis for the treatment of fractures of the mandibular condylar head in providing a high-quality durable fixation, while at the same time reducing the trauma necessary for an open approach to the fracture site.
  
  
  METHODS
  A preauricular approach was used for exposure, reduction, and osteosynthesis in 5 cases of type B condylar fractures. A cannulated screw system was used that allowed optimum placement of the self-cutting cannulated lag screw following insertion of a guiding wire and using clinical control to ensure its correct position. The joints were submitted to functional exercises immediately following surgery and postoperative radiologic, axiographic, and clinical follow-ups were performed.
  
  
  RESULTS
  Radiologic follow-up revealed correct reduction and fixation in all 5 cases. Axiographic and clinical follow-up showed an initial limitation, but normal mobility of the condyles was achieved within 3 months postoperatively, with a maximum mouth opening of 41.2 +/- 9.4 mm after 6 months. There were no occlusal disturbances, no trismus, no lateral deviations of the mandible, and no nerve lesions. Intraoperatively, the method applied shortened the time necessary for and simplified the procedure of reduction and osteosynthesis.
  
  
  CONCLUSIONS
  By using a cannulated lag screw, it was shown that the major factor in the extent of the trauma relating to surgical access was the reduction of the fracture fragments. The method ensured stable fixation of the fracture with a minimum of osteosynthesis material, while reducing the operative time. In combination with intraoperative imaging techniques it can also successfully be applied to other fractures in maxillofacial surgery.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technical University of Dresden, Dresden, Germany. eckart_pilling@yahoo.com
authors.forename: Eckart
authors.initials: E
authors.lastname: Pilling
authors.forename: Matthias
authors.initials: M
authors.lastname: Schneider
authors.forename: Ronald
authors.initials: R
authors.lastname: Mai
authors.forename: Richard A
authors.initials: RA
authors.lastname: Loukota
authors.forename: Uwe
authors.initials: U
authors.lastname: Eckelt
mesh_terms: D001696:Biomechanical Phenomena; D001863:Bone Screws; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008335:Mandibular Condyle / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D008337:Mandibular Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D011859:Radiography; D016896:Treatment Outcome