Abduction of the condyle head leads to condylar resorption: A radiologic study in children with intracapsular fractures

Zhou, Hai-Hua; Lv, Kun; Yang, Ruigang; Li, Zhi; Yang, Xuewen; Li, Zubing

doi:10.1016/j.ijporl.2019.05.013

Cited by 10 publications

(17 citation statements)

References 35 publications

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“…The horizontal absorption of the lateral process of the condyle after the closed treatment is surprising. The absorption of the residual condylar head is different from the resorption of the lateral condylar head because of the abduction of the condylar process 17 . Abduction leads to the ‘vertical absorption’ until condylar head located at the concentric position of the glenoid fossa.…”

Section: Discussionmentioning

confidence: 95%

Fracture fragment of the condyle determines the ramus height of the mandible in children with intracapsular condylar fractures treated conservatively

Yang

Cui

Zhou

et al. 2022

Sci Rep

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This study aimed to explore and impart understanding of bone remodelling in children with intracapsular fractures treated conservatively. Records of children (less than 12 years), who sustained intracapsular fractures and treated conservatively, were retrieved consecutively for the period of March 2011 to February 2016. Data about age, gender, date of injury, dates of admission and discharge, mechanism of trauma, location and pattern of fracture, other mandibular fractures, treatment methods and time of review were recorded and analysed. Image dates of pre- and post-treatments, including date of review, were also recorded. A total of 22 patients complete their follow-up and show bone remodelling process. During their follow-up, all the displaced condylar fragments fused with the ramus stump at the displaced position. Regardless of the type of conservative procedure, both treatments cannot promote the spontaneous fracture reduction in patients with intracapsular condylar fractures. During follow-up, the absorption of the lateral process of the condyle after the closed treatment becomes close to the ‘horizontal absorption’, until the height (or articular surface) of the lateral condylar process dropped and aligned to the articular surface of the medial process. In children with intracapsular condylar fractures, the fracture fragment of the condyle determines the ramus height of the mandible. Closed treatment cannot restore the fracture fragment. If the height of the fracture fragments dropped remarkably, then open reduction and rigid internal fixation become more suitable.

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Section: Discussionmentioning

confidence: 95%

Fracture fragment of the condyle determines the ramus height of the mandible in children with intracapsular condylar fractures treated conservatively

Yang

Cui

Zhou

et al. 2022

Sci Rep

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“…3,[6][7][8][9] However, whether the close treatment or open reduction of intra-capsular fractures, the results are not wholly satisfactory since there were so many reports of abnormal function and deformity in imaging findings. 2 Especially in patients with comminuted, small piece or old/delayed fractures, 10 the fragment may be too small to perform the reduction and fixation of the fracture, besides that its displacement may interfere or even avoid adequate occlusion and mouth opening reestablishment, correspondingly, some of the fracture fragments had to be removed during the surgical proce-dure. [11][12][13][14] However, few long-term follow-up reports exist on the removal of condyle fracture fragments.…”

Section: Referencesmentioning

confidence: 99%

“…Intracapsular fractures (also named ‘‘condylar head fractures’’ or ‘‘diacapitular fractures’’ or ‘‘sagittal fractures’’) are found most frequently in recent years, 1,2 due to the use of technique of coronal Computed Tomography (CT) scan. 3…”

mentioning

confidence: 99%

Removal of Fracture Fragments in Intracapsular Condylar Fractures: An Alternative Treatment Option

Cui¹,

Yang²,

Zhou

et al. 2022

Journal of Craniofacial Surgery

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Objective: This study aimed to explore bone remodeling after condylar fracture fragments have been removed from patients with intracapsular condylar fractures. it also evaluated whether condyle fracture removal can be used alternatively when the authors treat patients with comminuted or small pieces of fracture or in extremely difficult operations. Methods: Records of patients who sustained intracapsular condylar fractures and treated by removal of fragments for the period of February 2013 to September 2019 were retrieved. Data about age, gender, date of injury, dates of admission and discharge, mechanism of trauma, location and pattern of fracture, other mandibular fracture, treatment methods and time of review were recorded and analyzed. Image dates of pre- and post-treatment (including the time of review) were also recorded. Results: The data of a total of 103 patients ranging from 5 to 84 years old were retrieved during this study. A total of 135 sides of condylar fragments were removed. Almost all of the patients with comminuted condyle head fracture or type A fracture presented apparent shortening of the ramus height, and none of them showed osteogenesis (or new bone formation) during their follow-up. Present study only observed osteogenesis in few patients who sustained type B/C intracapsular condylar fractures during their follow-up. The younger the patient was, the longer the follow-up time was, and the higher the possibility of new bone formation was. No correlation was found between the amount of osteogenesis and follow-up time, the amount of osteogenesis was generally small, and no patient could form a new condyle head similar to the normal (or original) condyle head. Condylar hypertrophy only occurred in children. Four patients developed temporomandibular joint ankylosis. Conclusions: Removal of fracture fragments is an alternative treatment option for patients who sustained comminuted or small pieces of fracture or in extremely difficult operations.

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“…At the time of the first radiological examination, no abduction of the proximal fragment, especially the condylar head, was evident on the radiograph of the presented patient. Abduction of condyle is considered to be an essential prerequisite for condylar absorption in intracapsular fractures in children (68). Absorption of the condyle was a postoperative event that was detected in 35 of 140 condylar process fractures.…”

Section: Diagnosis Of Mandibular Condyle Traumamentioning

confidence: 99%

“…Absorption of the condyle was a postoperative event that was detected in 35 of 140 condylar process fractures. However, this bone loss required a considerable amount of time (about half a year with a wide spread of values) (68).…”

Section: Diagnosis Of Mandibular Condyle Traumamentioning

confidence: 99%

Preauricular Swelling Mimicking a Tumour: Dissolution of Mandibular Capitulum Following Trauma in a 15-Year Old Child

Friedrich

Kohlrusch

2020

In Vivo

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Aim: The report is about diagnosis, therapy, and follow-up of a 15-year old boy, who experienced facial swelling and impaired mouth opening after a sport accident. Case Report: Diagnosis of mandibular damage was delayed due to inadequate clinical investigation and radiography after trauma and only became clear after a parotid swelling occurred sometime later resulting from the dissolution of the upper part of the articular process. Follow-up control over a period of three years showed a partial restoration of the articular process but some inhibition of mouth opening combined with slight deviation of the mandible to the affected side remained over the years. Conclusion: This report reminds us that parotid swelling can be the result of mandibular trauma without a recent history of physical injury to this region. Therefore, the basic standards of radiologic diagnosis should be maintained and the limited restoring capacity of the condylar process in adolescence should be acknowledged.

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Abduction of the condyle head leads to condylar resorption: A radiologic study in children with intracapsular fractures

Cited by 10 publications

References 35 publications

Fracture fragment of the condyle determines the ramus height of the mandible in children with intracapsular condylar fractures treated conservatively

Fracture fragment of the condyle determines the ramus height of the mandible in children with intracapsular condylar fractures treated conservatively

Removal of Fracture Fragments in Intracapsular Condylar Fractures: An Alternative Treatment Option

Preauricular Swelling Mimicking a Tumour: Dissolution of Mandibular Capitulum Following Trauma in a 15-Year Old Child

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