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Published on: November 8, 2024
Open reduction and internal fixation with disc reduction for pediatric condylar fractures: three-dimensional CT
Jieyun Zhao1, Chuan Lu1, Huimin Zhu1
1Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Center for Stomatology & National Clinical Research Center for Oral Diseases, No. 639 Zhi Zao Ju Rd, Shanghai, 200011, China.
Purpose:
To evaluate the efficacy of open reduction and internal fixation (ORIF) with disc reduction for pediatric condylar fractures (CFs) and assess mandibular growth outcomes using three-dimensional (3D) CT measurement.
Materials And Methods:
Patients under 18 years with CF who underwent ORIF with disc reduction were recruited in the study. CT data including pre-operation, post-operation and at least 1 year follow-up were measured by ProPlan CMF 3.0 software for mandibular ramus height, mandibular body length, chin deviation and retrusion. Complications including bone resorption, fixation failure, temporomandibular joint ankylosis (TMJA), etc. were recorded.
Results:
18 patients with 25 condylar fractures were included in the study. There were 6 males and 12 females with the mean age of 13.44 years (SD 2.87). 40 % (n = 10) of them were intracapsular condylar fractures, 52 % (n = 13) were condylar neck fractures and 8 % (n = 2) were subcondylar fractures. After ORIF, the mandibular ramus height was restored 4.53 mm (SD 2.89). Chin deviation was corrected 3.87 mm (SD 2.29) and chin retrusion was improved 3.29 mm (SD 2.88). After an average follow-up of 26.39 months (SD 13.19), the ramus grew 2.48 mm (SD 3.87) with no progressing jaw deformity. There were no complications such as hardware failure and ankylosis.
Conclusions:
ORIF with disc reduction is effective for the treatment of pediatric CFs with regard to restoration of mandibular ramus height and prevention of progressive jaw deformity, bone resorption and ankylosis.
