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J Korean Assoc Oral Maxillofac Surg.  2017 Oct;43(5):343-350. 10.5125/jkaoms.2017.43.5.343.

Intracorporeal reduction of condylar fracture using both pedicled condylar and seperated ramal fragments after vertical ramal osteotomy

Affiliations
  • 1Division of Oral and Maxillofacial Surgery, Department of Dentistry, Inha University School of Medicine, Incheon, Korea. jjm0219@naver.com

Abstract

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.

Keyword

Mandibular fractures; Condylar fracture; Extracorporeal reduction; Intracorporeal reduction; Condylar resorption

MeSH Terms

Follow-Up Studies
Mandibular Fractures
Osteotomy*
Pterygoid Muscles
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