J Korean Assoc Oral Maxillofac Surg 2017; 43(5): 343~350
Intracorporeal reduction of condylar fracture using both pedicled condylar and seperated ramal fragments after vertical ramal osteotomy
Il-Kyu Kim, Jun-Min Jang, Hyun-Young Cho, Ji-Hoon Seo, Dong-Hwan Lee
Division of Oral and Maxillofacial Surgery, Department of Dentistry, Inha University School of Medicine, Incheon, Korea
Jun-Min Jang
Division of Oral and Maxillofacial Surgery, Department of Dentistry, Inha University Hospital, Inha University School of Medicine, 27 Inhang-ro, Jung-gu, Incheon 22332, Korea
TEL: +82-32-890-2470 FAX: +82-32-890-2475
E-mail: jjm0219@naver.com
ORCID: http://orcid.org/0000-0002-2484-2718
Received August 22, 2017; Revised September 28, 2017; Accepted September 29, 2017.; Published online October 31, 2017.
© Korean Association of Oral and Maxillofacial Surgeons. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
The aim of this study is to introduce a surgical technique that can maintain blood supply to prevent condylar resorption in the extracorporeal reduction of condylar fracture. Neither the medial pterygoid muscle on the ramal bone nor the lateral pterygoid muscle on the condylar fragment was detached after vertical ramal osteotomy. Thus, reduction was performed in the intracorporeal state. Therefore, blood supply was expected to be maintained to the fragments of both the condylar and ramal bones. On postoperative radiographs, the anatomical outline of the fractured condyle was well restored, and the occlusion was stable. In the unilateral case, there were no signs of mandibular condylar resorption until postoperative 3 weeks. In the 2 bilateral cases, condylar displacements with plate fractures and screw loosening were observed at postoperative 1 month or 5 months, but radiodensity at the displaced fracture site increased during the follow-up period. Finally, complete remodeling of the condylar fragments with restored anatomic appearance was observed on 8-month or 2-year follow-up radiographs. All cases exhibited good healing aspects with no signs or symptoms of mandibular condylar dysfunction during the postoperative remodeling period after intracorporeal reduction of condylar fracture.
Keywords: Mandibular fractures, Condylar fracture, Extracorporeal reduction, Intracorporeal reduction, Condylar resorption

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