[Extramedullary fixation combined with intramedullary fixation in the surgical reduction of sagittal mandibular condylar fractures].
OBJECTIVE
This study aimed to evaluate the clinical effect of extramedullary fixation combined with intramedullary fixation during the surgical reduction of sagittal mandibular condylar fractures.


METHODS
Twenty-four sagittal fractures of the mandibular condyle in18 patients were fixed by two appliances: intramedullary with one long-screw osteosynthesis or Kirschner wire and extramedullary with one micro-plate. The radiologically-recorded post-operative stability-associated com-plications included the screw/micro-plate loosening, micro-plate twisting, micro-plate fractures, and fragment rotation. The occluding relations, the maximalinter-incisal distances upon mouth opening, and the mandibular deflection upon mouth opening were evaluated based on follow-up clinical examination.


RESULTS
Postoperative panoramic X-ray and CT scans showed good repositioning of the fragment, with no redislocation or rotation, no screw/plate loosening, and no plate-twisting or fracture. Clinical examination showed that all patients regained normal mandibular movements, ideal occlusion, and normal maximal inter-incisal distances upon mouth opening.


CONCLUSIONS
Extramedullary fixation combined with intramedullary fixation is highly recommended for sagittal condylar fractures because of the anti-rotation effect of the fragment and the reasonable place-ment of the fixation appliances.
Stomatological School, Wannan Medical College, Wuhu 241002, China.
Chen
C
Chuanjun
Dept. of Oral and Maxillofacial Surgery, The Third Affiliated Hospital of Anhui Medical University, Hefei 230061, China.
Chen
C
Xiaoyang
Dept. of Stomatology, Anhui Jimin Tumor Hospital, Hefei 230011, China.
Chen
C
Jing
D001860:Bone Plates; D001863:Bone Screws; D005592:Fracture Fixation; D006801:Humans; D008334:Mandible; D008335:Mandibular Condyle; D008337:Mandibular Fractures; D011862:Radiography, Panoramic; D012399:Rotation
extramedullary fixation; intramedullary fixation; rigid internal fixation; sagittal condylar fracture