Condyle Fracture Fixed with Custom-Made Titanium Mesh and a Miniplate: A Case Report

Overview

Journal Am J Case Rep

Specialty General Medicine

Date 2023 Jun 28

PMID 37376731

Authors

Tadashi Kawai

Shinsuke Kawamata

Shuu Suzuki

Yuudai Ishikawa

Yuunosuke Ikeda

Erika Yasuge

Shintaro Kogi

Atsushi Ogawa

Mitsuru Izumisawa

Hiroyuki Yamada

Affiliations

Soon will be listed here.

Abstract

BACKGROUND Open reduction and internal fixation of condyle fractures are sometimes difficult for the upper region. This report presents a case of condyle fracture at the upper neck region treated with a custom-made titanium mesh and a titanium miniplate, which makes it easy to reposition the fragment and keep it in place. CASE REPORT A 20-year-old man was injured during a soccer match and was referred to our hospital with the symptom of trismus and deviation of the mandible to the left with an opened mouth. Fracture of the right condyle neck region was diagnosed; open reduction and internal fixation was planned under general anesthesia. A custom-made titanium mesh was prepared to make it easy to reposition the fragment and keep it in place because the reduction and fixation were expected to be difficult. The fracture region was exposed using the modified Risdon-Strasbourg approach. The segments were gripped with custom-made titanium mesh, and the condyle head was reduced easily. The segments were fixed with titanium mesh, a miniplate, and screws. Nine months after the operation, the mouth opening was good at 40 mm, there was no deviation of the mandible, and there was no breakage on the titanium mesh or plate. CONCLUSIONS This report presents a case of condyle fracture at the upper neck region reduced and fixed with a custom-made titanium mesh and a titanium miniplate, which make it easy to reposition the fragment and keep it in place.

Citing Articles

Optimal Plate Choice for High-Neck Mandibular Condyle Fracture: A Mechanistic Analysis of 16 Options.

Okulski J, Kozakiewicz M, Krasowski M, Zielinski R, Szymor P J Clin Med. 2024; 13(3).

PMID: 38337599 PMC: 10856367. DOI: 10.3390/jcm13030905.

References

Taalab D, Shehab A, Atef M, Shehab M . Comparative study between patient specific titanium plates versus conventional miniplates for treatment of mandibular fractures: Randomized clinical trial. J Craniomaxillofac Surg. 2023; 51(4):217-223. DOI: 10.1016/j.jcms.2023.01.015. View

Marwan H, Sawatari Y . What Is the Most Stable Fixation Technique for Mandibular Condyle Fracture?. J Oral Maxillofac Surg. 2019; 77(12):2522.e1-2522.e12. DOI: 10.1016/j.joms.2019.07.012. View

Petronis Z, Spaicyte N, Sakalys D, Januzis G . Functional Rehabilitation after Mandibular Fracture - A Systematic Review. Ann Maxillofac Surg. 2023; 12(2):197-202. PMC: 9976862. DOI: 10.4103/ams.ams_99_22. View

Merlet F, Grimaud F, Pace R, Mercier J, Poisson M, Pare A . Outcomes of functional treatment versus open reduction and internal fixation of condylar mandibular fracture with articular impact: A retrospective study of 83 adults. J Stomatol Oral Maxillofac Surg. 2017; 119(1):8-15. DOI: 10.1016/j.jormas.2017.10.007. View

Rastogi S, Sharma S, Kumar S, Reddy M, Indra B . Fracture of mandibular condyle—to open or not to open: an attempt to settle the controversy. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015; 119(6):608-13. DOI: 10.1016/j.oooo.2015.01.012. View

Schneider M, Stadlinger B, Loukota R, Eckelt U . Three-dimensional fixation of fractures of the mandibular condyle with a resorbable three-dimensional osteosynthesis mesh. Br J Oral Maxillofac Surg. 2011; 50(5):470-3. DOI: 10.1016/j.bjoms.2011.11.006. View

Sfondrini M, Gandini P, Alcozer R, Vallittu P, Scribante A . Failure load and stress analysis of orthodontic miniscrews with different transmucosal collar diameter. J Mech Behav Biomed Mater. 2018; 87:132-137. DOI: 10.1016/j.jmbbm.2018.07.032. View

Jin K, Lee H, Sohn J, Han Y, Jung D, Sim H . Fracture patterns and causes in the craniofacial region: an 8-year review of 2076 patients. Maxillofac Plast Reconstr Surg. 2018; 40(1):29. PMC: 6186527. DOI: 10.1186/s40902-018-0168-y. View

Yamashita Y, Inoue M, Aijima R, Danjo A, Goto M . Three-dimensional evaluation of healing joint morphology after closed treatment of condylar fractures. Int J Oral Maxillofac Surg. 2015; 45(3):292-6. DOI: 10.1016/j.ijom.2015.09.019. View

10.

Sukegawa S, Masui M, Kanno T, Miki M, Nakamoto H, Furuki Y . Evaluation of Open Reduction and Internal Fixation of Mandibular Condyle Fracture by Intraoperative Cone-Beam Computed Tomography in a Hybrid Operating Room. J Craniofac Surg. 2019; 31(3):762-765. PMC: 7329199. DOI: 10.1097/SCS.0000000000006101. View

11.

Shakya S, Zhang X, Liu L . Key points in surgical management of mandibular condylar fractures. Chin J Traumatol. 2019; 23(2):63-70. PMC: 7156880. DOI: 10.1016/j.cjtee.2019.08.006. View

12.

Janaphan K, Hashem I, Smith C, Holmes S, Chatzopoulou D . Periodontal disease as a primary cause of surgical site infection in fractures of the mandible: is smoking a confounding variable?. Br J Oral Maxillofac Surg. 2022; 60(10):1424-1429. DOI: 10.1016/j.bjoms.2022.08.001. View

13.

Satishchandran S, Umorin M, Manhan A, Abramowicz S, Amin D . Does the Treatment Approach for Mandibular Condyle Fractures Impact Self-Perceived Quality of Life?. J Oral Maxillofac Surg. 2022; 81(2):184-193. DOI: 10.1016/j.joms.2022.10.006. View

14.

Palanivel I, Narayanan V, Chandran S, Ramakrishnan K, Gurram P . Open Reduction Internal Fixation of Condylar Head/Diacapitular Fracture of Mandible: Case Series. J Maxillofac Oral Surg. 2021; 20(3):404-408. PMC: 8313619. DOI: 10.1007/s12663-020-01436-6. View

15.

Pamias-Romero J, Masnou-Pratdesaba J, Saez-Barba M, de-Pablo-Garcia-Cuenca A, Siurana-Montilva S, Sala-Cunill A . Personalized Surgery Service in a Tertiary Hospital: A Method to Increase Effectiveness, Precision, Safety and Quality in Maxillofacial Surgery Using Custom-Made 3D Prostheses and Implants. J Clin Med. 2022; 11(16). PMC: 9410390. DOI: 10.3390/jcm11164791. View

16.

Huang C, Chan M, Hsu J, Su K . Biomechanical analysis of subcondylar fracture fixation using miniplates at different positions and of different lengths. BMC Oral Health. 2021; 21(1):543. PMC: 8532336. DOI: 10.1186/s12903-021-01905-5. View

17.

Sri Surya T, Jaggannagari S, Danam R, Colvenkar S, Alwala A . Management of Comminuted Fracture of Mandible Using Titanium Mesh. Cureus. 2023; 15(3):e35799. PMC: 10073405. DOI: 10.7759/cureus.35799. View

18.

Landes C, Day K, Lipphardt R, Sader R . Closed versus open operative treatment of nondisplaced diacapitular (Class VI) fractures. J Oral Maxillofac Surg. 2008; 66(8):1586-94. DOI: 10.1016/j.joms.2007.06.668. View

19.

Sadhu Reddipogu J, Lightfoot E, Scott C, Thomas M . Recurrent mandibular fractures: a retrospective study over 17 years on aetiology, demographics, fracture patterns, and management. Int J Oral Maxillofac Surg. 2021; 50(12):1596-1602. DOI: 10.1016/j.ijom.2021.05.002. View

20.

Mooney S, Gulati R, Yusupov S, Butts S . Mandibular Condylar Fractures. Facial Plast Surg Clin North Am. 2021; 30(1):85-98. DOI: 10.1016/j.fsc.2021.08.007. View