title: Surgical treatment of sagittal fracture of mandibular condyle using long-screw osteosynthesis.
abstract: OBJECTIVE
  The retrospective study evaluated long-screw (bicortical screw) osteosynthesis used in the surgical treatment of sagittal fracture of the mandibular condyle and compared it with titanium plates and removal of the condylar fragment.
  
  
  METHODS
  Ninety-five patients with sagittal fracture of the mandibular condyle received open surgical treatment from 1997 to 2008. Among these patients, the condylar fragments were fixed with long screws in 56 cases (group A), were fixed with titanium plates in 12 cases (group B), and were completely removed in 24 cases (group C). Follow-up was carried out clinically and radiologically. The clinical features included limitation of mandibular mobility, occlusion disturbance, lateral deviation on mouth opening, joint pain, clicking, facial asymmetry, and patient's subjective evaluation. The radiologic parameters consisted of degree of bony resorption, bony change, change of osteosynthesis material, and shortening of mandibular ramus height.
  
  
  RESULTS
  Anatomic reduction and functional restoration were obtained and no severe complication was detected in group A. However, 3 of 14 patients had severe osteoarthrosis and 2 of 14 patients had ankylosis in group B. In group C 3 of 24 patients had mandibular retrusion, 4 of 24 patients had front teeth open bite, 4 of 24 patients had severe osteoarthrosis, and 1 of 24 patients had ankylosis.
  
  
  CONCLUSIONS
  The long-screw fixation group had a more favorable prognosis than the titanium plate group and the group in which removal of the condylar fragment was performed. The long-screw fixation technique might be suitable for use in the surgical treatment of sagittal fractures of the mandibular condyle.
authors.affiliation: Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
authors.forename: Shufang
authors.initials: S
authors.lastname: Luo
authors.forename: Bo
authors.initials: B
authors.lastname: Li
authors.forename: Xing
authors.initials: X
authors.lastname: Long
authors.forename: Mohong
authors.initials: M
authors.lastname: Deng
authors.forename: Hengxing
authors.initials: H
authors.lastname: Cai
authors.forename: Yong
authors.initials: Y
authors.lastname: Cheng
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000844:Ankylosis / Q000209:etiology; D018771:Arthralgia / Q000209:etiology; D001672:Biocompatible Materials / Q000737:chemistry; D001860:Bone Plates; D001862:Bone Resorption / Q000209:etiology; D001863:Bone Screws; D005146:Facial Asymmetry / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008310:Malocclusion / Q000209:etiology; D008335:Mandibular Condyle / Q000293:injuries* / Q000601:surgery; D008337:Mandibular Fractures / Q000601:surgery*; D008875:Middle Aged; D024343:Open Bite / Q000209:etiology; D010003:Osteoarthritis / Q000209:etiology; D017060:Patient Satisfaction; D011183:Postoperative Complications; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D013705:Temporomandibular Joint Disorders / Q000209:etiology; D014025:Titanium / Q000737:chemistry; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001672:Biocompatible Materials; D014025:Titanium