• Title/Summary/Keyword: Condylar fractures

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COMPARISON OF CONSERVATIVE AND SURGICAL TREATMENT OF CONDYLAR FRACTURES OF MANDIBLE (하악과두 골절 치료에 있어 보존적 치료와 외과적 치료의 비교)

  • Lee, Cheol-Woo;Yeo, Hwan-Ho;Kim, Young-Gyun;Lee, Hyo-Bin;Byun, Woong-Rae;Park, In-Soon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.1
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    • pp.79-87
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    • 1994
  • The authors investigated the 17 patients with the condylar fractures of the mandible who were admitted in Dept. of Oral and Maxillofacial Surgery, Chosun University, Dental hospital from 1990 to 1993 and could be taken follow-up above 6 months. Helkimo's clinical dysfunction index and mandibular mobility index were applied to the evaluation of the patients and the obtained results were as follows. 1. Mean maximal mouth opening was 38.4 mm in the conservative group, 41.3 mm in the surgical group and that showed no statistically significant difference.(P>0.05) 2. Clinical dysfunction index was higher in the surgical group than in the conservative group but .that showed no statistically difference.(P>0.05) 3. The extent of maximal mouth opening was increased gradually throughout the follow-up period. 4. Both groups didn't show severe clinically dysfunction.

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Surgical Treatment of Ipsilateral Multi-Level Femoral Fracture Treated Using Antegrade Intramedullary Nail

  • Kim, Beom-Soo;Cho, Jae-Woo;Yeo, Do-Hyun;Oh, Jong-Keon
    • Journal of Trauma and Injury
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    • v.31 no.2
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    • pp.96-102
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    • 2018
  • Ipsilateral fractures of proximal femur with shaft and condylar region are very rare. Current concept of management is based on fixation of each fracture as independent entity using separate fixation modalities for proximal and distal parts of femur. However, we considered that antegrade femoral nailing with cephalomedullary screw fixation is a good option for ipsilateral multi-level femoral fractures. Here, we present an experience of satisfactory treatment for ipsilateral femoral neck fracture, subtrochanteric fracture, comminuted shaft fracture with supracondylar fracture following road traffic accident.

A CLINICO-RADIOLOGIC STUDY OF BONY REMODELING OF THE FRACTURED CONDYLES IN CHILDREN (소아에서 골절된 하악과두의 골개조 양상에 관한 임상 및 방사선학적 연구)

  • Cho Jeong-Shin;Park Chang-Seo
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.25 no.2
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    • pp.471-482
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    • 1995
  • Bony remodeling pattern of condyle fractures in children are different from in adult for growing of condyle, also might affect treatment and prognosis of the condyle fracture. Subjects of this clinical and radiologic study were 26 temporomandibular joints diagnosed as condyle fracture in 23 patients under 15 years old age. They were treated with conservative method at Dental Hospital of Yonsei University from Jan., 1986 to Oct., 1994. Bony remodeling related with fracture pattern was evaluated. The results obtained are as follows: 1. The ratio of male to female in patients with condyle fracture was 1 : 0.9 and the difference of sex ratio was not noted. Comparing with preschool-age group and school-age group, age frequency was higher in preschool-age group(83%). 2. Fallen down(54%) was the most frequent cause of condyle fractures. Traffic accident and slip down were followed. 3. The most common clinical sign of condyle fractures was tenderness to paipation09 cases). Mouth opening limitation07 cases), swelling(7 cases), malocclusion(3 cases) were next in order. 4. According to sites of condyle fractures, unilateral fractures were in 20 patients and bilateral fractures in 3 patients, therefore total 23 patients-26 cases of condyle fracture were observed. According to fracture distribution, condyle fractures were in 10 patients(44%). Condyle fractures with symphysis fracture(9 patients, 39%), condyle fractures with ascending ramus fracture(2 patients, 9%), condyle fracture with mandibular body fracture(1 patient, 4%), and condyle fractures with mandibular angle fracture(1 patient, 4%) were followed. 5. In displacement pattern of fractured fragment of mandibular condyle, dispiacement(17 cases, 66%) was most common. Dislocation(5 cases, 19%) and deviation (4 cases, 15%) were next in order. 6. During the observation period of fractured condyles, remodeling patterns of fracture sites related with articular fossa were observed with usual condylar shape in 23 cases and with prominently different shape in 3 cases.

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FUNCTIONAL TREATMENT OF PEDIATRIC CONDYLAR FRACTURES : A CASE REPORT (Activator를 이용한 소아의 하악과두골절의 치험례)

  • Lee, Jung-Ha;Park, Heon-Dong;Lee, Sang-Ho;Lee, Nan-Young
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.3
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    • pp.477-482
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    • 2003
  • The pediatric condylar fracture occurs very frequently in the mandible, but this injury is occasionally ignored due to difficulty of diagnosis and no cooperation of patient. The adequate initial diagnosis and active treatment must be performed because delayed and improper treatment lead to possible severe complication such as TMJ ankylosis and reta rdation of mandibular development. Most pediatric condylar fracture is mainly performed by the conservative or functional treatment, but it may be required open reduction according to cases. In this study, activator is applied for functional treatment of pediatric condylar fracture and fair recovery of jaw function is acquired.

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FUNCTIONAL DYNAMIC REDUCTION OF THE FRACTURED MANDIBULAR CONDYLE IN THE CHILDREN: REPORTOF CASES (Benoist 장치에 의한 성장기 하악과두 골절 치험 3예)

  • Kim, Jong-Hoon;Oh, Bong-Woon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.15 no.3
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    • pp.211-216
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    • 1993
  • This is to report functional treatment, as mechano-therapy, of condylar fracture in cases of growing patients. Benoist's appliance was used in 3 cases condylar fractures, provides extraoral elastic forces to external pterygoid muscle. The appliance providing guided exercise of masticatory muscles induces transformative growth of trauma-tic condyles. The results were as follow; 1. Early exercise preventes ankylosis of fractured condyle. 2. Optimal physical exercise therapy induces the normal growth pattern by muscular training and bony remodeling of fractured condyle in children.

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Clinical study of maxillofacial trauma of children (소아 구강악안면 영역의 외상에 관한 임상적 연구)

  • Kim, Hak-Ryeol;Kim, Yeo-Gab
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.1
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    • pp.43-52
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    • 2010
  • Purpose: To research about maxillofacial traumatic injuries of children in aspects of gender difference, various incidence rates between age, trauma type, cause, monthly and daily incidence rate, type of tooth damage, gingival damage, soft tissue damage, and type of facial bone fracture. Materials and methods: Study group consisted of children under 15 years of age who visited Dental Hospital, School of Dentistry, Kyung Hee University from 2004/7/1 to 2007/6/30 with chief complaint of oral and maxillofacial traumatic injuries. 1,559 cases of traumatic injuries were studied from 1,556 (1,004 male, 552 female) children. Conclusion: 1. There were slightly more boys than girls, giving a male-to-female ratio of 1.82:1.0. The 1-3 year old boys and girls had the highest number of traumatic injuries. 2. Of the 1,556 patients, 68.63% had soft tissue injuries, 50.22% had periodontal injuries, 29.89% had teeth injuries, and 3.85% had maxillofacial bone fractures. 3. Falling down was the most common cause of injury in both sexes. 4. The months with the highest incidence rates were in order May (12.12%), June (11.74%), and October (11.13%). Most of the injuries occurred on weekends. 5. The most common tooth injury was uncomplicated crown fracture, and the most common periodontal injury was subluxation. The majority of traumatizes teeth were the upper central incisors. 6. The most common soft tissue injury was intraoral lacerations. 7. Mandibular fractures were most frequent in facial bone fractures; symphysis, condylar head, and angle fractures were most frequent in mandibular fractures; maxillary and nasal bone fractures were most frequent in midfacial bone fractures.

Comparative study on the osseous changes of the TMJ and mandibular asymmetry after conservative or operative treatment in condylar fracture patients

  • Yu Su-Kyoung;Kim Kyung-A;Kwon Ki-Jeong;Koh Kwang-Joon
    • Imaging Science in Dentistry
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    • v.33 no.4
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    • pp.223-229
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    • 2003
  • Purpose: To compare the effects of the conservative treatment and operative treatment by observation of osseous changes of the TMJ and mandibular asymmetry in condylar fracture patients. Materials and Methods: 33 condylar fracture patients (17 with conservative and 16 with operative treatment) were included in this study. After a minimum of 6 months after the surgical procedure, patients were given a follow up examination of the osseous changes using a transcranial view. Differences in the osseous changes of both groups were compared and the asymmetry indices were calculated on a postero-anterior skull view. Results: The TMJ of the operative treatment group showed more significant osseous changes than the conservative treatment group. The affected TMJ showed more significant osseous changes than the unaffected TMJ in the both groups. The unaffected TMJ of the conservative group and the affected TMJ of the operative group showed significant osseous changes. The mandibular asymmetry indices in the conservative and operative group were 5.12 and 7.30 respectively at the time of treatment, and 2.39 and 3.41 respectively at the follow-up. But the mandibular asymmetry between the both groups showed no statistical differences. Conclusion: The TMJ of the operative group showed more significant osseous changes than the conservative group, but the mandibular asymmetry between the both groups showed no statistical difference.

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Case Report of Transparotid Approach of Mandibular Subcondylar Fracture (하악골 과두하 골절의 이하선 경유 접근법을 통한 관혈적 정복술 증례보고)

  • Moon, Mincheol;Oh, Suk Joon;Koh, Seoung Hoon
    • Archives of Craniofacial Surgery
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    • v.10 no.1
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    • pp.33-36
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    • 2009
  • Purpose: Fractures of the mandibular condylar area are common injuries that account for 29% to 40% of fractures of the facial bones and represent 20% to 62% of all mandibular fractures. Currently 3 main methods are being used in the treatment of mandibular subcondylar fractures: closed reduction; open reduction and internal fixation; Endoscopic reduction and internal fixation. Each method has its proponents and opponent as well as advantages and disadvantages, and indications for each vary among surgeons. There are six approaches of open reduction: submandibular, retromandibular, preaurilcular, postauricular, intraoral, transparotid approach. Among them, transparotid approach has been described for subcondylar exposure with dissection in the direction of facial nerve fibers to expose the bone through the parotid gland. This approach carries the risk of a parotid glandular fistula as well as facial nerve injury but has the advantage of being directly over the fracture site. We report safety and efficacy of surgical treatment using a transparotid approach for direct plating. Methods: A 43-year-old man sustained multiple facial bone fractures by driver traffic accident. Mandibular subcondyle was fractured and dislocated internally. We performed open reduction and internal fixation by transparotid approach. Fractured site was fixed by titanium mini plate & screw. We applicated arch bar for approximately 3 weeks. Results: Follow-up length was about 5months. Scar of surgical incision was indistinct, there was no symptoms and signs of facial nerve and parotid gland injury, and maximal mouth opening was measured 49.5 mm. Conclusion: Transparotid approach has high risks of facial nerve and parotid gland injury, but paradoxically it is the most effective technique in saving facial nerve. Open reduction and internal fixation of mandibular subcondylar fracture by transparotid approach with precise and versed procedure, best outcome can be expected.

Trauma severity and mandibular fracture patterns in a regional trauma center

  • Lee, Hyeok;Kim, Kwang Seog;Choi, Jun Ho;Hwang, Jae Ha;Lee, Sam Yong
    • Archives of Craniofacial Surgery
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    • v.21 no.5
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    • pp.294-300
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    • 2020
  • Background: Mandibular fractures are one of the most common types of facial fractures, the treatment of which can be delayed due to the severity of the trauma resulting in an increase of complications; thus, early evaluation of trauma severity at the time of visit is important. In South Korea, trauma patients are triaged and intensively treated in designated regional trauma centers. This study aimed to analyze the relationship between trauma severity and mandibular fracture patterns. Methods: A medical records review was performed on patients who visited the regional trauma center at our hospital for mandibular fracture between 2009 and 2018. Epidemiologic data and mandibular fracture patterns were analyzed and compared with the conventional facial injury severity scale (FISS). Results: Among 73 patients, 51 were classified as non-severe trauma patients and 22 as severe trauma patients. A higher trauma severity was associated with older age (odds ratio [OR], 1.164; 95% confidence interval [CI], 1.057-1.404) and lower risk was associated with fractures located in the angle (OR, 0.001; 95% CI, 0-0.022), condylar process (OR, 0.001; 95% CI, 0-0.28), and coronoid process (OR, 0.004; 95% CI, 0-0.985). The risk was lower when the injury mechanism was a pedestrian traffic accident (OR, 0.004; 95% CI, 0-0.417) or fall (OR, 0.004; 95% CI, 0-0.663) compared with an in-car traffic accident. Higher FISS (OR, 1.503; 95% CI, 1.155-2.049) was associated with a higher trauma severity. The proposed model was found to predict the trauma severity better than the model using FISS (p< 0.001). Conclusion: Age, location of mandibular fractures, and injury mechanism showed significant relationships with the trauma severity. Epidemiologic data and patterns of mandibular fractures could predict the trauma severity better than FISS.