Basic and patient-oriented researchSoft Tissue Reduction During Open Treatment of Intracapsular Condylar Fracture of the Temporomandibular Joint: Our Institution's Experience
Section snippets
Patients
From June 2004 to May 2009, 129 patients (164 TMJs) with ICF underwent open surgeries in the TMJ division of Shanghai's Ninth People's Hospital. Of the patients, 90 were male and 39 female. Ages ranged from 4 to 80 years (mean, 32.2 yrs). The right side was involved in 53 patients, the left in 41, and bilaterally in 35.
Most fractures were the result of a fall while riding or walking (72 cases), traffic accidents (29 cases), falls because of vertigo (14 cases), physical aggression (7 cases),
Surgical Findings
In our group, inferomedial displacement of bony fragment and soft tissue injury of the TMJ complex was found in all cases (Table 3). Disc disruption occurred in 4 TMJs that were type M and reconstructed by costochondral graft and deep temporalis fascia. Inferomedial displacement of the condylar segment and disc occurred in 160 TMJs (97.6%) (Fig 3A). Adhesion of superior joint space was found in 37 of 160 TMJs (23.1%) in which the duration between trauma and operation was more than 20 days.
Discussion
Newly developed techniques of osteosynthesis of ICF have led to satisfying results, but they pay close attention to the reduction and fixation of the condylar process. There were still some complications related not only to osteosynthesis but also to soft tissue. Vesnaver7 found reciprocal clicking on mouth opening in 13%. Hlawitschka et al12 reported that, despite good osseous reduction, destruction of the disc ligament system led to an irregular movement process in 40% of the group treated
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