• Maxillofacial Plastic and Reconstructive Surgery
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• v.19 no.2
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• pp.167-180
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• 1997

79 surgically managed mandibular condylar fracture patients included the 25 patients treated with Dr, Nam's method were analysed the postoperative resluts in Oral and Maxillofcial Surgery, School of Dentistry, Wonkwang University since 1993 to 1995. Mean patient's age is 32.5 years (range, 8 to 65 years), and follow-up periods were a minimum of 3 months to 28 months. 19% condylar fractures were associated with mostly symphysis portion. According to the patient's age, severity of condylar fractures, clinical signs and symptoms, radiographic findings, treatmenet plans had been performed. Rigid fixation have performed greatly, and then fragment removal of fractured mesial pole of proximal segment of the condylar and little cases of reshaping and eminoplasty and lag screw have been applied. Two cases of the both condylar resorption and deviated condyle posteriorly in Dr. Nam's method. None of infection or necrosis signs of treated condyle surgically. In my opinion, whenever possible, displaced condylar fracture can be managed surgically with rigid fixation, but not Dr. Nam's method. Usually if perform the surgical management of condylar fractures you should maintain maxillomandibular fixation for 2 weeks, or more and has to follow-up functional mandibular exercise should be kept continuously.

• Journal of the korean academy of Pediatric Dentistry
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• v.47 no.1
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• pp.1-8
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• 2020

The aim of this retrospective study was to investigate etiology, clinical features, and treatment modalities of the mandibular condyle fracture in children and young adolescents. This study was conducted based on medical records and radiographic examinations of 44 pediatric patients. Patients received treatment under diagnosis of mandibular condylar fracture. They were divided into 4 groups according to their age. The involvement of condyle in the mandible fracture occurred in higher percentage in younger age groups. Falling was the most common etiologic factor in all age group, especially in children with age under 7. Condyle head was the most frequent site of fracture in age group of 4 - 7 whereas fracture tends to occur in lower condylar areas in older groups. In 54.5% of the mandibular condyle fracture, symphysis fracture was accompanied. Teeth injury occurred in higher incidency when condyle fracture accompanied symphysis fracture. Conservative treatments were applied to 43 out of 44 patients.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.11 no.1
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• pp.93-100
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• 1989

This is a report of comparison of condyle fracture treatment by functional treatment and surgical treatment. In cases of functional therapy, mode of action of Activator that we used; By fulcrum of posterior teeth, the mandibular elevators of the opposite side cause the gap in the dental arches to be reduced, while the mandible performs a rotational movement about the fulcrum during which the fracture surface of the large fragment moves downward. Condylar fractures are often seen in association with fractures of other regions of the mandible. In our department, such cases were treated by miniplate and intramaxillary fixation. Surgical treatment of fractures of the mandible condylar were treated by intraoral approach. The result were drawn as follows : 1. Lateral displacement of condyle ; functional therapy with activator. 2. Compound fracture ; miniplate osteosynthesis and physiotherapy. 3. Anteriormedially displacement ; surgical treatment.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.24.1-24.7
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• 2016

Background: This study aimed to evaluate the structural changes of temporomandibular joint immediately after condylar fractures with magnetic resonance imaging (MRI). Method: We evaluated 34 subjects of condylar fractures with MRI. The position, shape, and signal intensity of the condyle, disc, and retrodiscal tissue were analyzed with MR images. Results: Immediately after trauma, the disc was displaced with the fractured segment in almost all cases. And, the changes of signal intensity at the retrodiscal tissue were found but less related to the degree of fracture displacement. And, the high signals were observed almost at all fractured joint spaces and even at some contralateral joints. Conclusions: The displaced disc as well as the increased signal intensity of the joint space, condylar head, and retrodiscal tissue demands more attention to prevent the possible sequela of joint.

• 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.

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.3
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• pp.378-385
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• 2018

Mandibular fractures occur with high incidence among various fractures in maxillofacial region in children. Jaw fractures in children should be approached differently than in adults because bone growth continues throughout childhood. As far as displacement of the fragment is not severe, or if it is condyle that is fractured, closed reduction and additional intermaxillary fixation can be considered. Functional exercise is also required to prevent ankylosis of temporomandibular joint. Several complications, particularly malocclusion and facial asymmetry due to growth disturbances, can occur after condylar fractures. If growth disturbances take place after mandibular fractures, catch-up growth may occur in some patients, thus, periodic observation is necessary. In case of persistent growth disturbances, functional devices may be used to prevent severe facial asymmetry. This case report describes the long-term follow-up of two patients with facial asymmetry after mandibular fracture.

• 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.

• The Journal of the Korean dental association
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• v.55 no.10
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• pp.696-705
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• 2017

Condylar fractures account for one-third of all mandibular fractures. There are many surgical methods for the open reduction of condylar fractures, such as the transoral, submandibular, preauricular, and retromandibular approaches. Two patients suffering from condylar fractures, a 45-year-old man and a 25-year-old man, were admitted to our hospital. Both patients' condylar fractures were positioned too high for us to use the transoral approach. Therefore, we employed the retromandibular method to expedite the approach to the fracture site and minimize the size of the incision. After the surgical procedures in both cases, we experienced complications in the form of parotid gland fistulae, which rarely result from the retromandibular approach. A combination of botulinum toxin injection and amitriptyline medication was effective for the management of these parotid gland fistulae. Here, we report these two cases and offer a review of the literature on this article.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.1
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• pp.31-39
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• 2001

The purpose of this study is to reveal the factors leading to the problem of unilateral condylar fractures and suggest a treatment guideline of treatment for good prognosis in surgical treatment. The factors can be age, sex, fracture site, degree of displacement, posterior occlusion loss, post-operative alteration of condylar head position, post-operative condylar head resorption, and maxillomandibular fixation period. One hundred and eleven patients with unilateral condylar fractures, who were treated by surgical method from 1990 Feb. to 2000 Feb., were studied. Minimum follow-up period was 6 months. The results were as follows ; 1. In the age group of $41{\sim}60$, females had significantly higher complication rate than males, therefore we must be careful about treatment of female in this age group 2. In level I fractures of the mandibular condyle, because there were abundant complications when the patients were treated with fragment removal, conservative treatment is recommended over the surgical approach. 3. There were no differences in the complication rate, in the level II, III fractures. but were severe complications in the cases of patients treated by Dr.Nam's method or fragment removal. Therefore, open reduction and internal fixation is recommended over Dr.Nam's method or fragment removal. 4. In level IV fractures, open reduction and internal fixation is recommended 5. Although there was a higher complication rate depending on the degree of deviation, there was no correlation between the degree of deviation and development of complications in each level of fracture 6. Because the complication rate was higher in cases of condylar resorption, vertical dimension loss, and alteration of condylar head position, we must make an effort to prevent such complications during treatment

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.44 no.2
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• pp.73-78
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• 2018

Objectives: The goal of this study was to evaluate the rates of complications, morbidity, and safety with the transparotid approach. Materials and Methods: A retrospective study was conducted and consisted of 53 surgically treated patients in the past five years for low condylar neck and subcondylar fractures. Only patients with malocclusion and who underwent open reduction with internal fixation with the retromandibular transparotid approach were included. The examined parameters were postoperative suboptimal occlusion, deflection, saliva fistula, and facial nerve weakness. Results: Fifty-three patients had an open reduction with internal fixation on 55 sides (41 males, 77.4%; mean age, 42 years [range, 18-72 years]). Four patients (7.5%) experienced transient facial nerve weakness of the marginal mandibular branch, but none was permanent. Four patients had a salivary fistula, and 5 patients showed postoperative malocclusion, where one needed repeat surgery after one year. One patient showed long-term deflection. No other complications were observed. Conclusion: The retromandibular transparotid approach is a safe procedure for open reduction and internal fixation of low condylar neck and subcondylar fractures, and it has minimal complications.