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Research Article| Volume 58, ISSUE 4, P432-436, May 2020

New surgical instrument for the treatment of condylar fractures: the digitised condylar retractor

  • C. Han
    Affiliations
    State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, PR China
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  • J. Cui
    Affiliations
    State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, PR China
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  • X. Zhang
    Affiliations
    State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, PR China
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  • K. Li
    Affiliations
    State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, PR China
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  • L. Liu
    Correspondence
    Corresponding author. Tel.: +86 28 85503406, Fax: +86 28 85582167.
    Affiliations
    State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, PR China
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Published:February 11, 2020DOI:https://doi.org/10.1016/j.bjoms.2020.01.027

      Abstract

      Reduction is one of the most difficult steps in condylar fracture surgery, and a key factor governing the postoperative outcome. In this study we evaluated quantitatively the effects of a digitised condylar retractor on the duration and rate of reduction. In a prospective, randomised, controlled clinical trial, 48 patients with unilateral condylar fractures who were listed for surgical treatment were randomised to an experimental and a control group (n = 24 in each). The experimental group was treated with a digitised condylar retractor, and the control group with traditional surgical instruments only. The primary outcome variables were duration and rate of reduction. The continuity correction chi squared test and independent samples t test were used for statistical analyses. The results showed that the mean reduction time was 21.3 minutes in the experimental group and 42.4 minutes in the control group (p = 2.48*10−8, <0.001). The reduction rate was 21/24 in the experimental group and 17/24 in the control group (p = 0.16). The results indicated that the mean duration of reduction was significantly shorter, and the reduction rate was higher, in the experimental group than among controls. In conclusion, the digitised condylar retractor can assist surgeons to improve efficiency and accuracy in the reduction of condylar fractures, so it merits promotion as an aid to their surgical treatment.

      Keywords

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      References

        • Motamedi M.H.K.
        An assessment of maxillofacial fractures: A 5-year study of 237 patients.
        J Oral Maxillofac Surg. 2003; 61: 61-64
        • Giannakopoulos H.E.
        • Quinn P.D.
        • Granquist E.
        • et al.
        Posttraumatic temporomandibular joint disorders.
        Craniomaxillofac Trauma Reconstr. 2009; 2: 091-101
        • Hlawitschka M.
        • Loukota R.
        • Eckelt U.
        Functional and radiological results of open and closed treatment of intracapsular (diacapitular) condylar fractures of the mandible.
        Int J Oral Maxillofac Surg. 2005; 34: 597-604
        • Kermer C.H.
        • Undt G.
        • Rasse M.
        Surgical reduction and fixation of intracapsular condylar fractures. A follow up study.
        Int J Oral Maxillofac Surg. 1998; 27: 191-194
        • Abdel-Galil K.
        • Loukota R.
        Fractures of the mandibular condyle: evidence base and current concepts of management.
        Br J Oral Maxillofac Surg. 2010; 48: 520-526
        • Laskin D.M.
        Management of condylar process fractures.
        Oral Maxillofac Surg Clin North Am. 2009; 21: 193-196
        • He D.
        • Yang C.
        • Chen M.
        • et al.
        Modified preauricular approach and rigid internal fixation for intracapsular condyle fracture of the mandible.
        J Oral Maxillofac Surg. 2010; 68: 1578-1584
        • Kheradpir A.R.
        • Chien A.T.
        • Julian III, R.S.
        Transoral osteosynthesis of subcondylar fractures of the mandible using a fenestrated Levassier-Merrill retractor.
        J Oral Maxillofac Surg. 2011; 69: 2006-2011
        • Sabesan T.
        • Peters W.J.
        Modified plastic spatula: a condylar retractor.
        Br J Oral Maxillofac Surg. 2006; 44: 412-413
        • Roche S.J.
        • Sproule J.A.
        • Murthy G.E.
        Unicondylar phalangeal fracture reduction using a sponge-holding forceps: a safe and effective technique.
        J Hand Surg Eur Vol. 2010; 35: 509-511
        • Schneider M.
        • Lauer G.
        • Eckelt U.
        Surgical treatment of fractures of the mandibular condyle: a comparison of long-term results following different approaches – functional, axiographical, and radiological findings.
        J Craniomaxillofac Surg. 2007; 35: 151-160
        • Schneider M.
        • Erasmus F.
        • Gerlach K.L.
        • et al.
        Open reduction and internal fixation versus closed treatment and mandibulomaxillary fixation of fractures of the mandibular condylar process: a randomized, prospective, multicenter study with special evaluation of fracture level.
        J Oral Maxillofac Surg. 2008; 66: 2537-2544
        • Choi B.H.
        • Huh J.Y.
        • Yoo J.H.
        Computed tomographic findings of the fractured mandibular condyle after open reduction.
        Int J Oral Maxillofac Surg. 2003; 32: 469-473