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Oral and maxillofacial surgery Online only article| Volume 115, ISSUE 1, e4-e9, January 2013

Closed reduction of mandibular condyle fractures using C-arm fluoroscopy: a technical note

Published:April 27, 2012DOI:https://doi.org/10.1016/j.oooo.2011.08.018
      We describe a C-arm technique for mandibular condylar fractures in an anatomic study using a model skull and show its feasibility in a clinical case. The C-arm allowed posterior-anterior visualization of the condylar process. The X-ray axis was canted ∼15 degrees cranially to the Frankfort horizontal line. The skull's sagittal plane was rotated ∼15 degrees ipsilaterally to the X-ray axis. This technique facilitates clear visualization of the condylar neck with easy, flexible, and timely adjustments. In selected cases, this method would convert the clinical settings of the condylar fracture pattern to that which would not be amenable to an open approach, making possible minimally invasive surgical procedures.
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      References

        • Laskin D.M.
        Management of condylar process fractures.
        Oral Maxillofac Surg Clin North Am. 2009; 21: 193-196
        • Abdel-Galil K.
        • Loukota R.
        Fractures of the mandibular condyle: evidence base and current concepts of management.
        Br J Oral Maxillofac Surg. 2010; 48: 520-526
        • Ellis 3rd, E.
        Method to determine when open treatment of condylar process fractures is not necessary.
        J Oral Maxillofac Surg. 2009; 67: 1685-1690
        • Chen C.T.
        • Feng C.H.
        • Tsay P.K.
        • Lai J.P.
        • Chen Y.R.
        Functional outcomes following surgical treatment of bilateral mandibular condylar fractures.
        Int J Oral Maxillofac Surg. 2011; 40: 38-44
        • Smets L.M.
        • van Damme P.A.
        • Stoelinga P.J.
        Nonsurgical treatment of condylar fractures in adults: a retrospective analysis.
        J Craniomaxillofac Surg. 2003; 31: 162-167
        • Imai T.
        • Michizawa M.
        • Fujita G.
        • Shimizu H.
        • Ota Y.
        • Kitamuta T.
        • et al.
        C-Arm–guided reduction of zygomatic fractures revisited.
        J Trauma. 2011; 71: 1371-1375
        • Griffin Jr, J.E.
        • Max D.P.
        • Frey B.S.
        The use of the C-arm in reduction of isolated zygomatic arch fractures: a technical overview.
        J Cranio Maxillofac Trauma. 1997; 3: 27-31
        • Badjate S.J.
        • Cariappa K.M.
        C-Arm for accurate reduction of zygomatic arch fracture—a case report.
        Br Dent J. 2005; 199: 275-277
        • Czerwinski M.
        • Parker W.L.
        • Beckman L.
        • Williams H.B.
        Rapid intraoperative zygoma fracture imaging.
        Plast Reconstr Surg. 2009; 124: 888-898
        • Chen R.F.
        • Chen C.T.
        • Hao Chen C.
        • Liao H.T.
        • Chen Y.R.
        Optimizing closed reduction of nasal and zygomatic arch fractures with a mobile fluoroscan.
        Plast Reconstr Surg. 2010; 126: 554-563
        • Boutros S.G.
        Closed reduction and fluoroscopically assisted percutaneous stabilization of displaced subcondylar mandible fractures.
        Plast Reconstr Surg. 2005; 116: 971-977
        • Brandt M.T.
        • Haug R.H.
        Open versus closed reduction of adult mandibular condyle fractures: a review of the literature regarding the evolution of current thoughts on management.
        J Oral Maxillofac Surg. 2003; 61: 1324-1332
        • Stanley Jr, R.B.
        Use of intraoperative computed tomography during repair of orbitozygomatic fractures.
        Arch Facial Plast Surg. 1999; 1: 19-24
        • Adeyemo W.L.
        • Akadiri O.A.
        A systematic review of the diagnostic role of ultrasonography in maxillofacial fractures.
        Int J Oral Maxillofac Surg. 2011; 40: 655-661
        • Gellrich N.C.
        • Schramm A.
        • Hammer B.
        • Rojas S.
        • Cufi D.
        • Lagrèze W.
        • Schmelzeisen R.
        Computer-assisted secondary reconstruction of unilateral posttraumatic orbital deformity.
        Plast Reconstr Surg. 2002; 110: 1417-1429
        • Yu H.
        • Shen G.
        • Wang X.
        • Zhang S.
        Navigation-guided reduction and orbital floor reconstruction in the treatment of zygomatic-orbital-maxillary complex fractures.
        J Oral Maxillofac Surg. 2010; 68: 28-34
        • Siessegger M.
        • Mischkowski R.A.
        • Schneider B.T.
        • Krug B.
        • Klesper B.
        • Zöller J.E.
        Image guided surgical navigation for removal of foreign bodies in the head and neck.
        J Craniomaxillofac Surg. 2001; 29: 321-325
        • Gupta M.
        • Iyer N.
        • Das D.
        • Nagaraj J.
        Analysis of different treatment protocols for fractures of condylar process of mandible.
        J Oral Maxillofac Surg. 2012; 70: 83-91
        • Iizuka T.
        • Lädrach K.
        • Geering A.H.
        • Raveh J.
        Open reduction without fixation of dislocated condylar process fractures: long-term clinical and radiologic analysis.
        J Oral Maxillofac Surg. 1998; 56: 553-561