title: Finite element analysis of type B condylar head fractures and osteosynthesis using two positional screws.
abstract: OBJECTIVE
  The aim of this study was to explore the cause of type B condylar head fracture after parasymphyseal impact, and evaluate the biomechanics of osteosynthesis using two positional screws for the repair of this type of fractures.
  
  
  METHODS
  A finite element model of the mandible was created, and a parasymphyseal impact was simulated using Mimics 10.01 and Abaqus 6.10 software. The type B condylar head fracture was simulated in the right condyle using a mimics simulation cut with polyplane module according to the analyzed results together with clinical experience, and the left condyle was used as a control. Two positional screws were used for rigid internal fixation of the fracture. von Mises stress distributions in the condyles and screws were analyzed.
  
  
  RESULTS
  The von Mises stress generated in parasymphyseal trauma simulation showed a significant concentration in the sagittal direction of the condyle. In two-positional-screw osteosynthesis of the condylar head fractures, stress concentration appeared within the screws in the gap area between the two fractured segments and the area around the screw head. A small amount of stress was distributed in the screw holes and on the posterior surfaces of both segments. The von Mises stress was negligible in the fractured sagittal surfaces.
  
  
  CONCLUSIONS
  It is reasonable to attribute the cause of type B condylar head fracture to the anatomical features of the condyle. The biomechanics of two-positional-screw osteosynthesis revealed that the stress can transmit through the screws to the medial fragments, and the stresses on both sagittal fractured surfaces are minimal.
authors.affiliation: Department of Oral & Cranio-Maxillofacial Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai 200011, People's Republic of China.
authors.forename: Pengfei
authors.initials: P
authors.lastname: Xin
authors.affiliation: Department of Plasticity Engineering, Shanghai Jiao Tong University, Shanghai 200030, People's Republic of China.
authors.forename: Bin
authors.initials: B
authors.lastname: Jiang
authors.affiliation: Department of Oral & Cranio-Maxillofacial Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai 200011, People's Republic of China.
authors.forename: Jiewen
authors.initials: J
authors.lastname: Dai
authors.affiliation: Department of Plasticity Engineering, Shanghai Jiao Tong University, Shanghai 200030, People's Republic of China.
authors.forename: Guanghong
authors.initials: G
authors.lastname: Hu
authors.affiliation: Department of Oral & Cranio-Maxillofacial Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai 200011, People's Republic of China.
authors.forename: Xudong
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Oral & Cranio-Maxillofacial Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai 200011, People's Republic of China.
authors.forename: Bing
authors.initials: B
authors.lastname: Xu
authors.affiliation: Department of Oral & Cranio-Maxillofacial Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai 200011, People's Republic of China. Electronic address: maxillofacsurg@163.com.
authors.forename: Steve G F
authors.initials: SG
authors.lastname: Shen
mesh_terms: D001696:Biomechanical Phenomena; D001732:Bite Force; D001863:Bone Screws; D003198:Computer Simulation; D005260:Female; D020342:Finite Element Analysis; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D008335:Mandibular Condyle / Q000293:injuries*; D008337:Mandibular Fractures / Q000209:etiology* / Q000601:surgery; D008953:Models, Anatomic; D008954:Models, Biological; D013314:Stress, Mechanical; D055815:Young Adult
keywords: Biomechanics; Condylar head fracture; Elastic modulus; Rigid internal fixation; Stability