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Complications of condylar fracture osteosynthesis
Leila Derfoufi1, Christophe Delaval, Patrick Goudot
1Oral and Maxillo-facial Surgery Department, Lapeyronie Hospital, University Hospital of Montpellier, Montpellier, France.
Background:
Condylar fracture osteosynthesis is today commonly practiced, but only a few studies deal with complications due to plates or screws loosening.
Methods:
We made a retrospective analysis of 53 operated condylar fractures treated with different fixation devices from July 2002 to July 2007. We looked for complications and its relationship with the osteosynthesis device used.
Results:
We found 11.3% complications due to plate fracture, plate torsion, or screw loosening. Those occurred at 2.75 months after surgery on average.
Discussion:
When performing condyle osteosynthesis, one must keep in mind that plates must be located on the posterior border of the ramus and below the mandibular incisure to respect mastication strains. In our study, the number of plates or the number of screws per plate was not always ideal. Moreover, we started active physiotherapy the day after surgery, which is too early because titanium plates are too weak to support all the mandibular strains. A well-adapted osteosynthesis associated with a progressive load of the temporomandibular joint should limit postoperative plate fracture or torsion.
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