title: Minimally-invasive open reduction of intracapsular condylar fractures with preoperative simulation using computer-aided design.
abstract: Reduction of intracapsular condylar fractures is difficult, so we have based our technique on preoperative simulation using computer-aided design (CAD), which has proved useful in other surgical specialties. We have treated 11 patients with intracapsular condylar fractures. Before the operation the procedure was shown on the computer using a three-dimensional simulation system. The relation between the stump and the fragment of the condyle, and assessment of the position and the size of the screw, were made preoperatively to obtain a perfect fit. The displaced fragment was reduced by elevators, and fixed with a bicortical screw through a minimised preauricular incision under general anaesthesia. The fragments and the location of the screws were similar on the preoperative simulation and on the postoperative computed tomographic (CT) scan. The reduction and fixation of the fracture showed a perfect fit on the same view in the preoperative CAD simulation in the Mimics 10.01 software and postoperatively. Postoperative clinical examinations showed good occlusion and satisfactory mouth opening. Two patients had temporary paralysis of the occipitofrontalis muscle that recovered within 3 months. All patients regained normal mandibular movements and had short and invisible scars at 6 months' follow up. The technique of CAD simulation could help to improve the accuracy during open treatment for intracapsular condylar fractures.
authors.affiliation: Department of Oral-Maxillofacial Surgery, The Affiliated Hospital of Stomatology, China Medical University, 117 Nanjing-Bei Street, Heping District, Shenyang, 110002, China.
authors.forename: Ming-liang
authors.initials: ML
authors.lastname: Yang
authors.forename: Bin
authors.initials: B
authors.lastname: Zhang
authors.forename: Qing
authors.initials: Q
authors.lastname: Zhou
authors.forename: Xiao-bo
authors.initials: XB
authors.lastname: Gao
authors.forename: Qiang
authors.initials: Q
authors.lastname: Liu
authors.forename: Li
authors.initials: L
authors.lastname: Lu
mesh_terms: D000328:Adult; D001863:Bone Screws; D002921:Cicatrix / Q000145:classification; D003198:Computer Simulation; D017076:Computer-Aided Design; D003766:Dental Occlusion; D005152:Facial Muscles / Q000503:physiopathology; D005158:Facial Paralysis / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D017746:Joint Capsule / Q000293:injuries* / Q000601:surgery; D004204:Joint Dislocations / Q000601:surgery; D008297:Male; D008335:Mandibular Condyle / Q000293:injuries* / Q000601:surgery; D008337:Mandibular Fractures / Q000601:surgery*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D008953:Models, Anatomic; D011183:Postoperative Complications; D016059:Range of Motion, Articular / Q000502:physiology; D013704:Temporomandibular Joint / Q000293:injuries / Q000601:surgery; D036542:Tomography, Spiral Computed / Q000379:methods; D016896:Treatment Outcome