A retrospective study of temporomandibular joint ankylosis secondary to surgical treatment of mandibular condylar fractures.
We investigated the incidence of ankylosis of the temporomandibular joint (TMJ) after open operations for fractures of the mandibular condyle, and analysed possible risk factors in a total of 385 patients with 492 condylar fractures who had been operated on in our department from 2001 to 2010. Sixteen patients developed postoperative ankylosis of the TMJ with 26 joints (5%) affected during a follow-up of 6 months-10 years. Of the 492 condylar fractures, the most common ones that were associated with postoperative ankylosis were those of the condylar head (20/248), followed by the condylar neck (6/193). Subcondylar fractures did not cause postoperative ankylosis (0/51). Among the 16 patients with postoperative ankylosis, 13 had associated anterior mandibular fractures. Long-screw (bicortical screw) fixation of fractures of the condylar head seemed to be associated with a lower incidence of postoperative ankylosis than fixation by miniplate and wire or removal of the fractured fragment. The articular discs were damaged in all ankylosed joints, and the remaining fractured fragment was found in 10 ankylosed joints after fractures of the condylar head. The results suggest that fractures of the condylar head are more prone to lead to postoperative ankylosis of the TMJ, and that the possible risk factors seem to include the technique used for fixation and damage to the disc, together with an anterior mandibular fracture with the fractured fragment remaining.
Department of Oral and Maxillofacial Surgery, Puai Hospital of Tongji Medical College, Huazhong University of Science and Technology, Hanzheng Street 473, Wuhan 430033, PR China; The State Key Laboratory Breeding Base of Basic Science of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education, Department of Oral and Maxillofacial Surgery, School & Hospital of Stomatology, Wuhan University, Luoyu Road 237, Wuhan 430079, PR China.
Guo-lin
GL
Xiang
The State Key Laboratory Breeding Base of Basic Science of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education, Department of Oral and Maxillofacial Surgery, School & Hospital of Stomatology, Wuhan University, Luoyu Road 237, Wuhan 430079, PR China. Electronic address: longxing_china@hotmail.com.
Xing
X
Long
The State Key Laboratory Breeding Base of Basic Science of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education, Department of Oral and Maxillofacial Surgery, School & Hospital of Stomatology, Wuhan University, Luoyu Road 237, Wuhan 430079, PR China.
Mo-hong
MH
Deng
Department of Oral and Maxillofacial Surgery, Puai Hospital of Tongji Medical College, Huazhong University of Science and Technology, Hanzheng Street 473, Wuhan 430033, PR China.
Qian-chao
QC
Han
The State Key Laboratory Breeding Base of Basic Science of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education, Department of Oral and Maxillofacial Surgery, School & Hospital of Stomatology, Wuhan University, Luoyu Road 237, Wuhan 430079, PR China.
Qing-gong
QG
Meng
The State Key Laboratory Breeding Base of Basic Science of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education, Department of Oral and Maxillofacial Surgery, School & Hospital of Stomatology, Wuhan University, Luoyu Road 237, Wuhan 430079, PR China.
Bo
B
Li
D000293:Adolescent; D000328:Adult; D000844:Ankylosis / Q000209:etiology*; D001860:Bone Plates; D001863:Bone Screws; D001864:Bone Wires; D002358:Cartilage, Articular / Q000293:injuries / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation; D006801:Humans; D008297:Male; D008335:Mandibular Condyle / Q000293:injuries* / Q000601:surgery; D008337:Mandibular Fractures / Q000601:surgery*; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D019224:Temporomandibular Joint Disc / Q000293:injuries / Q000601:surgery; D013705:Temporomandibular Joint Disorders / Q000209:etiology*; D055815:Young Adult
Ankylosis; Condylar fractures; Surgery; Temporomandibular joint