Surgical Treatment of Intracapsular Condylar Head Fracture with Lag Screw Technique. A Case Report

Intracapsular condylar fractures may account for 65% of all condylar fractures. This diversity of classifications makes epidemiological data collection challenging. Historically, intracapsular condylar fractures were treated in a closed or conservative manner, without open surgery and fixation of the bone fragments. Closed treatment has been described with acceptable outcomes without the risk of complications associated with the surgical treatment, that is, infection, damage to the facial nerve, and unaesthetic extra-oral scar. Recently, studies reporting the surgical treatment of condylar head fractures have reported better results regarding mandibular functional aspects, dental, and aesthetic results. It is also suggested that the repositioning of the articular disc during the surgical procedure, could prevent the consequences of its displacement in possible temporomandibular joint dysfunctions. The objective of this study is to report a clinical case of intracapsular condylar head fracture with open treatment, using lag screw fixation according to AO/ASSIF (Arbeitsgemeinschaft für Osteosynthesefragen/Association for the Study of Internal Fixation) protocols and recommendations.

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New Persistent Opioid Use and Associated Risk Factors Following Treatment of Ankle Fractures

Foot & Ankle International ◽

10.1177/1071100719851117 ◽

2019 ◽

Vol 40 (9) ◽

pp. 1043-1051 ◽

Cited By ~ 5

Author(s):

Timothy D. Gossett ◽

Fred T. Finney ◽

Hsou Mei Hu ◽

Jennifer F. Waljee ◽

Chad M. Brummett ◽

...

Keyword(s):

Risk Factors ◽

Surgical Treatment ◽

Ankle Fracture ◽

Opioid Use ◽

Patient Factors ◽

Distal Fibula ◽

Opioid Prescription ◽

Opioid Dose ◽

Closed Treatment ◽

Open Treatment

Background:The aim of this study was to define the rate of new persistent opioid use and risk factors for persistent opioid use after operative and nonoperative treatment of ankle fractures.Methods:Using a nationwide insurance claims database, Clinformatics DataMart Database, we identified opioid-naïve patients who underwent surgical treatment of unstable ankle fracture patterns between January 2009 and June 2016. Patients who underwent closed treatment of a distal fibula fracture served as a comparative group. We evaluated peritreatment and posttreatment opioid prescription fills. The primary outcome, new persistent opioid use, was defined as opioid prescription fulfillment between 91 and 180 days after the procedure. Logistic regression was used to evaluate the effect of patient factors, and the differences of the effect were tested using Wald statistics. The adjusted persistent use rates were calculated. A total of 13 088 patients underwent treatment of an ankle fracture and filled a peritreatment opioid prescription.Results:When compared with closed treatment of a distal fibula fracture, only 2 surgical treatment subtypes demonstrated significantly increased rates of persistent use compared with the closed treatment group: open treatment of bimalleolar ankle fracture (adjusted odds ratio [aOR], 1.32; 95% CI, 1.10-1.58; P = .002) and open treatment of trimalleolar ankle fracture with fixation of posterior lip (aOR, 1.47; 95% CI, 1.04-2.07; P = .027). Rates were significantly increased (aOR, 1.56; 95% CI, 1.34-1.82; P < .001) among patients who received a total peritreatment opioid dose that was in the top 25th percentile of total oral morphine equivalents. Factors independently associated with new persistent opioid use included mental health disorders, comorbid conditions, tobacco use, and female sex.Conclusion:All ankle fracture treatment groups demonstrated high rates of new persistent opioid use, and persistent use was not directly linked to injury severity. Instead, we identified patient factors that demonstrated increased risk of persistent opioid use. Limiting the peritreatment opioid dose was the largest modifiable risk factor related to new persistent opioid use in this privately insured cohort.Level of Evidence:Level III, retrospective cohort study.

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Open Treatment with Ultrasound Activated Resorbable Pins Versus Closed Treatment of Adult Mandible Condylar Head Fractures

Journal of Maxillofacial and Oral Surgery ◽

10.1007/s12663-021-01631-z ◽

2021 ◽

Author(s):

Poonam Yadav ◽

Vidya Rattan ◽

Sachin Rai ◽

Satnam Singh Jolly

Keyword(s):

Closed Treatment ◽

Open Treatment ◽

Condylar Head

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Current Opinions on Surgical Treatment of Fractures of the Condylar Head

Craniomaxillofacial Trauma & Reconstruction ◽

10.1055/s-0034-1371772 ◽

2014 ◽

Vol 7 (2) ◽

pp. 92-100 ◽

Cited By ~ 16

Author(s):

Paolo Boffano ◽

Rodolfo Benech ◽

Cesare Gallesio ◽

Francesco Arcuri ◽

Arnaldo Benech

Keyword(s):

Surgical Treatment ◽

Temporomandibular Joint ◽

Current Knowledge ◽

Mandibular Condyle ◽

Bone Screws ◽

Functional Movement ◽

Anatomical Position ◽

Open Treatment ◽

Condylar Head

Treatment of mandibular condyle fractures is still controversial, with surgical treatment slowly becoming the preferred option. However, fractures of the condylar head (diacapitular fractures) are still treated conservatively at many institutions. Recently, more and more surgeons have begun to perform open treatment for diacapitular fractures because it allows to restore the anatomical position of the fragments and disc, it allows an immediate functional movement of the jaw, and avoid the ankylosis of the temporomandibular joint induced by the trauma. Several techniques have been proposed to reduce and fix fractures of the condylar head, such as standard bone screws, resorbable screws, resorbable pins, and cannulated lag screws. Therefore, the aim of this article is to review the literature about the surgical treatment of fractures of the condylar head to resume the current knowledge about open treatment of such fractures.

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Surgical Treatment of Adult Mandibular Condylar Fractures Provides Better Outcomes Than Closed Treatment: A Systematic Review and Meta-Analysis

Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.joms.2014.09.027 ◽

2015 ◽

Vol 73 (3) ◽

pp. 482-493 ◽

Cited By ~ 66

Author(s):

Essam Ahmed Al-Moraissi ◽

Edward Ellis

Keyword(s):

Systematic Review ◽

Surgical Treatment ◽

Meta Analysis ◽

Closed Treatment ◽

Condylar Fractures

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Epidemiological Profile of Intracerebral Hemorrhage during a 10-Year Period in a Southern Brazilian Region

Arquivos Brasileiros de Neurocirurgia Brazilian Neurosurgery ◽

10.1055/s-0037-1617426 ◽

2018 ◽

Vol 37 (01) ◽

pp. 7-12

Author(s):

Timóteo Almeida ◽

Fernanda Almeida ◽

Luidia Giacomini ◽

Andressa Niederauer ◽

Anna Cho ◽

...

Keyword(s):

Surgical Treatment ◽

Intracerebral Hemorrhage ◽

Epidemiological Data ◽

International Classification Of Diseases ◽

Spontaneous Intracerebral Hemorrhage ◽

Anticoagulant Drugs ◽

Classification Of Diseases ◽

Icd 10 ◽

Epidemiological Profile

Objective Spontaneous intracerebral hemorrhage is responsible for 20% of all cases of cerebrovascular accidents, which might lead to functional disabilities and death. There are few epidemiological data on spontaneous intracerebral hemorrhage in Brazil, and more specifically in the southern region of the country. Methods We reviewed data of 221 patients with intracerebral hemorrhage who attended our department between January of 2004 and December of 2013 and were registered as I61 and I62 according to the 10th edition of the International Classification of Diseases and Related Health Problems (ICD-10). Results From the 221 cases, 53.8% were male, and the median age was 63 years old. Arterial hypertension was reported in 62.4% of the patients. Surgical treatment was performed in 28.9% of all cases and pneumonia affected 19.9%. In 73.4% of the cases, the patients died or were severely disabled at discharge. We found an association of heart disease, coagulopathies, chronic kidney disease, anticoagulant drugs use, surgical treatment, and pneumonia with a poorer outcome. Conclusion The present study describes the epidemiological profile of intracerebral hemorrhage in a southern Brazilian population during a 10-year period.

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Conservative Approach to Unilateral Condylar Fracture in a Growing Patient: A 2.5-Year Follow Up

The Open Dentistry Journal ◽

10.2174/1874210601206010001 ◽

2012 ◽

Vol 6 (1) ◽

pp. 1-4 ◽

Cited By ~ 8

Author(s):

Elif Bahar Tuna ◽

Aysun Dündar ◽

Abdülkadir Burak Çankaya ◽

Koray Gençay

Keyword(s):

Conservative Treatment ◽

Mouth Opening ◽

Facial Asymmetry ◽

Mandibular Growth ◽

Fractures In Children ◽

Facial Swelling ◽

Direct Pressure ◽

Condylar Head ◽

Condylar Fractures

Condylar fractures in children are especially important because of the risk of a mandibular growth-center being affected in the condylar head, which can lead to growth retardation and facial asymmetry. The purpose of this article is to follow up the two and half year clinical and radiological evaluation of the conservative treatment of a 10 year-old patient, who had a unilateral green-stick type fracture. The patient presented with painful facial swelling localized over the left condylar region, limited mouth-opening and mandibular deviation to the left. Panoramic radiography and computed tomography confirmed the diagnosis of incomplete fracture on the left condyle with one side of the bone fractured and the other bent. Closed reduction was chosen to allow for initial fibrous union of the fracture segments and remodeling with a normal functional stimulus. A non-rigid mandibular splint was applied in order to remove the direct pressure on the fracture side of the mandible. Clinical and radiologic examination after 30 months revealed uneventful healing with reduction of the condylar head and remodeling of the condylar process following conservative treatment.

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Methods of Reconstructive Surgical Treatment for Patients with Defects and Pseudarthroses of Femur

N.N. Priorov Journal of Traumatology and Orthopedics ◽

10.17816/vto201017465-70 ◽

2010 ◽

Vol 17 (4) ◽

pp. 65-70

Author(s):

Valentina Afanas'evna Kopysova ◽

V A Kaplun ◽

A N Svetashov ◽

V V Shashkov ◽

V A Kopysova ◽

...

Keyword(s):

Surgical Treatment ◽

Shape Memory ◽

Shape Memory Effect ◽

Memory Effect ◽

Weight Bearing ◽

Bone Defects ◽

Femoral Bone ◽

Treatment Results ◽

Stable Osteosynthesis ◽

Bone Fragments

Treatment results of 59 patients with femoral bone defects and diaphyseal pseudarthroses were analyzed. To substitute bone defects of more than 6 cm permeable porous endoprostheses were used. In patients with normotrophic and hypertrophic pseudarthrosis stable osteosynthesis with interfragmental compression of bone fragments by shape-memory-effect tightening bows was performed. In patients with atrophic pseudarthrosis bone plasty with autograft was applied. In all patients the weight-bearing ability of the affected limb was restored. Total restoration of function was achieved in 75.6% of patients.

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