Journal of Prevention and Treatment for Stomatological Diseases ›› 2021, Vol. 29 ›› Issue (7): 474-478.doi: 10.12016/j.issn.2096-1456.2021.07.007

• Clinical Study • Previous Articles     Next Articles

Retrospective analysis of the treatment of mandibular condylar sagittal fracture with Kirschner wire in 13 cases

WANG Ke(),PENG Guoguang(),HE Shanzhi,TAN Yulian   

  1. Stomatological Medical Center, Foshan Hospital of Traditional Chinese Medicine, Foshan 528000, China
  • Received:2020-12-27 Revised:2021-03-02 Online:2021-07-20 Published:2021-04-19
  • Contact: Guoguang PENG E-mail:keke820403@163.com;guoguang828@yahoo.com.cn
  • Supported by:
    Guangdong Medical Research Fund Project(B2021425);Foshan Key Medical Specialty Training Project(Fspy3-2015018)

Abstract:

Objective To evaluate the value of Kirschner wire internal fixation in the treatment of sagittal mandibular condylar fractures.Methods From January 2019 to January 2020, 13 patients (19 sides) with mandibular condylar sagittal fracture treated by Kirschner wire internal fixation at the Stomatological Medical Center, Foshan Hospital of Traditional Chinese Medicine were retrospectively analyzed. After conventional surgical incision and exposure and reduction of the mandibular condyle, 2-4 Kirschner wires were used for fixation, and other maxillofacial fractures were treated simultaneously. The reduction accuracy and stability of the free mandibular condyle were evaluated by CBCT one week after the operation, and the occlusion relationship, opening degree and opening type were evaluated by clinical examination.Results All patients had good fracture alignment and no twisting, breaking or loosening of the Kirschner wire. The occlusion relationship, opening degree and opening shape recovered well after the operation.Conclusion Kirschner wire is effective in treating sagittal fractures of mandibular condyles.

Key words: mandibular condyle, temporomandibular joint, sagittal fracture, single condylar fracture, bilateral condyle fracture, cone beam CT, rigid internal fixation, Kirschner wire, titanium plate, occlusion relationonship, opening degree, opeing shape

CLC Number: 

  • R78

Table 1

Clinical data of 13 cases of sagittal fracture of mandible condyle treated with Kirschner wire"

Case Sex Age(year) Fracture type Methods of condylar internal fixation HB grading Imaging evaluation
1 Male 29 CF2 L: KW × 3; R: KW × 3 Fracture reduction
2 Male 38 CF2+MSF L: KW × 3+FP × 1; R: KW × 4 Fracture reduction
3 Female 45 CF1 R: KW × 3 Fracture reduction
4 Male 19 CF1 R: KW × 3 Fracture reduction
5 Male 16 CF1 L: KW × 2 Fracture reduction
6 Female 52 CF2+MSF L: KW × 2; R: KW × 4 Fracture reduction
7 Female 46 CF1 L: KW × 4 Fracture reduction
8 Male 27 CF2+MSF R: KW × 4; L: KW × 2+FP × 1 Fracture reduction
9 Male 23 CF1 R:KW × 3 Fracture reduction
10 Male 49 CF1 L:KW × 3 Fracture reduction
11 Male 55 CF2 L: KW × 4; R: KW × 3 Fracture reduction
12 Male 68 CF2 L: KW × 3; R: KW × 3 Fracture reduction
13 Female 32 CF1 R: KW × 3 Fracture reduction

Figure 1

Typical cases of sagittal fracture of the mandibular condyle treated with Kirschner wire a: preoperative panoramic CBCT film, bilateral high condylar fracture, the fracture block is displaced, and the height of the ascending ramus of the mandible is reduced; b: CBCT shows the right condyle fracture was fixed with four Kirschner wires; c: CBCT shows the left condyle fracture was fixed with two Kirschner wires and one titanium plate; d: panoramography at one week after operation, there was no prominent condylar cortical bone, and bilateral sagittal condylar fractures were anatomically reduced; e: panoramography at one year after operation, removal of internal fixation, the condylar fracture lines on both sides have healed; f-g: one year after operation, CBCT shows that after the removal of bilateral condylar internal fixation, the articular head-joint concave relationship is normal, and the condyle is in a moderate position; CBCT: cone beam CT"

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