RESUMEN
INTRODUCTION: The incidence of condylar fractures is high. Condylar fractures can be extracapsular (condylar neck or subcondylar) or intracapsular, undisplaced, deviated, displaced or dislocated. Treatment depends on the age of the patient, the co-existence of other mandibular or maxillary fractures, whether the condylar fracture is unilateral or bilateral, the level and displacement of the fracture, the state of dentition and the dental occlusion, and the surgeon's experience. PURPOSE: This report presents the experience acquired in the treatment of 466 condylar fractures over 7 years, reviews the pertinent literature and proposes guidelines for treatment. MATERIAL AND METHODS: The archives of KAT, General District Hospital between 1995 and 2002 were scrutinized and the condylar fractures were recorded. The aetiology, age, sex, level of fracture, degree of displacement, associated facial fractures, malocclusion, and type of treatment were noted. RESULTS: Four hundred and sixty-six condylar fractures were admitted, the male:female ratio was 3.5:1. Road traffic accidents were the main cause and most fractures were unilateral, displaced, subcondylar, occurred on the left side and were treated conservatively. CONCLUSIONS: Early mobilization is the key in treating condylar fractures. Whilst rigid internal fixation provides stabilization and allows early mobilization, conservative treatment is the treatment of choice for the majority of fractures. Children and intracapsular fractures are treated conservatively with or without maxillo-mandibular fixation. Open reduction is recommended in selected cases to restore the occlusion, in severely displaced and dislocated fractures, in cases of loss of ramus height, and in edentulous patients. It may be considered in those with 'medical problems' where intermaxillary fixation is not recommended.
Asunto(s)
Cóndilo Mandibular/lesiones , Fracturas Mandibulares/cirugía , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Niño , Protocolos Clínicos , Huesos Faciales/lesiones , Femenino , Fijación Interna de Fracturas , Humanos , Técnicas de Fijación de Maxilares , Luxaciones Articulares/cirugía , Luxaciones Articulares/terapia , Masculino , Maloclusión/complicaciones , Fracturas Mandibulares/clasificación , Persona de Mediana Edad , Estudios Retrospectivos , Factores Sexuales , Fracturas Craneales/complicacionesRESUMEN
Trigeminal neuralgia, which may involve one or more branches of the trigeminal nerve, is considered to produce one of the most severe types of pain. As it may be associated with other conditions, in some cases, the patient is subjected to unnecessary treatment. A case of nonidiopathic trigeminal neuralgia associated with internal carotid aneurysm, is presented.