Closed treatment of pediatric dislocated intracapsular condylar fractures with mandibular retrusion using orthodontic appliance

Abstract

Abstract: PURPOSE : To introduce a non-surgical method of treating pediatric dislocated condylar fracture associated with symphyseal fracture and malocclusion. METHODS : A nine-year-old boy was transferred to our hospital 15 days after injury. He was diagnosed as symphyseal fracture with bilateral dislocated condylar fracture, lower arch expansion and mandibular retrusion. Herbst appliance was designed and manufactured. Under general anesthesia, dislocated condyles and expanded dental arch were reduced manipulatively. The Herbst appliance was fitted as well. RESULTS : The Herbst appliance was removed 1 month after wearing. During follow-up period, bilateral fractured condyles healed and remodeled well. Normal occlusal relationship was regained as well as mandibular function. CONCLUTIONS: Herbst appliance was feasible in treating patients with mandibular retrusion resulting from intracapsular condylar fractures.

Key words: Pediatric, Mandibular fracture, Condylar fracture, Closed treatment, Functional appliance

CLC Number:

R782.4

TANG Yan-mei, XU Bin, NIE Ping, WANG Xiao-ling, XUE Xiao-chen, ZHU Min.. Closed treatment of pediatric dislocated intracapsular condylar fractures with mandibular retrusion using orthodontic appliance[J]. China Journal of Oral and Maxillofacial Surgery, 2015, 13(6): 550-553.

References

[1] Bormann KH, Wild S, Gellrich NC, et al. Five-year retrospective study of mandibular fractures in Freiburg, Germany: incidence, etiology, treatment, and complications [J]. J Oral Maxillofac Surg, 2009, 67(6): 1251-1255.
[2] Christiano JG, Dorafshar AH, Tufaro AP, et al. Closed reduction of laterally displaced fracture/dislocation of the mandibular condylar process in a child [J]. J Craniofac Surg, 2011, 22(4): 1504-1506.
[3] Chrcanovic BR. Open versus closed reduction: diacapitular fractures of the mandibular condyle [J]. Oral Maxillofac Surg, 2012, 16(3): 257-265.
[4] Thorén H, Iizuka T, Hallikainen D, et al. An epidemiological study of patterns of condylar fractures in children [J]. Br J Oral Maxillofac Surg, 1997, 35(5): 306-311.
[5] 李晓宇, 刘政华, 蔡剑波. 17例儿童髁突骨折保守治疗的临床分析 [J]. 国际口腔医学杂志, 2012, 39(6): 733-735.
[6] Deleyiannis FW, Vecchione L, Martin B, et al. Open reduction and internal fixation of dislocated condylar fractures in children: long-term clinical and radiologic outcomes [J]. Ann Plast Surg, 2006, 57(5): 495-501.
[7] Thorén H, Hallikainen D, Iizuka T, et al. Condylar process fractures in children: a follow-up study of fractures with total dislocation of the condyle from the glenoid fossa [J]. J Oral Maxillofac Surg, 2001, 59(7): 768-773.
[8] He D, Cai Y, Yang C. Analysis of temporomandibular joint ankylosis caused by condylar fracture in adults [J]. J Oral Maxillofac Surg, 2014, 72(4): 763. e761-769.
[9] 邱蔚六, 张震康, 王大章. 口腔颌面外科理论与实践 [M]. 北京: 人民卫生出版社, 1998: 818.
[10] Feng Z, Li L, He D, et al. Role of retention of the condylar cartilage in open treatment of intracapsular condylar fractures in growing goats: three-dimensional computed tomographic analysis [J]. Br J Oral Maxillofac Surg, 2012, 50(6): 523-527.
[11] 邱蔚六. 邱蔚六口腔颌面外科学[M]. 上海: 上海科学技术出版社, 2008: 850.
[12] Grow JN, Flores RL, Tholpady SS. Repair of a pediatric bilateral condylar and symphyseal fracture using a transfacial Steinman pin [J]. J Craniofac Surg, 2014, 25(2): e133-136.
[13] 蔡怡华, 陆川, 何冬梅, 等. 儿童髁突囊内骨折外脱位合并颏部骨折的治疗:附1例报告[J].中国口腔颌面外科杂志,2014,12(3): 281-284.
[14] 冯智强, 何冬梅, 杨驰. 儿童髁突骨折诊断和治疗的现状与展望 [J]. 口腔颌面外科杂志, 2008, 18(6): 439-442.
[15] 段沛沛, 梅李. 固定功能矫治器的发展和应用 [J]. 国际口腔医学杂志, 2010, 37(5): 569-572.