Risk of mandibular canal injury on insertion of an intramedullar pin. Experimental study based on the morphology of major fragments in fractures

Autor:	Young-Sung Kim, Haruyasu Tanabe, Akihiro Ikai, Masashi Sugisaki
Rok vydání:	1999
Předmět:	business.industry medicine.medical_treatment Mandible Dentistry Mandibular canal Standard plane Condyle medicine.anatomical_structure stomatognathic system medicine Mandibular plane business Reduction (orthopedic surgery) Mandibular ramus
Zdroj:	Japanese Journal of Oral & Maxillofacial Surgery. 45:100-105
ISSN:	2186-1579 0021-5163
DOI:	10.5794/jjoms.45.100
Popis:	An intramedullarpin inserted from the base of the mandible in used for open reduction of fractures of the mandibular condylar prosess. However, depending on the morphology of the mandible, there is some risk of mandibular canal injury during insertion. In most cases, the condylar process in dislocated. It is therefore difficult to estimate the risk of mandibular canal injury during insertion when the method we described previously, which is based on the tangent of the posterior border of the mandibular ramus, is used preoperatively. In this study, instead of using a tangent that is difficult to measure in fractures, we deduced a virtual standard plane of the mandibular ramus from the morphologic characteristics of the major fragment and used it to estimate the risk of mandibular canal injury. Namely, we calculated the angle of the posterior border of the mandible from a virtual standard plane, using the x-ray films of 37 Japanese dry skulls, and estimated the probability of injury. The results were as follows.When the pin was aimed towards the superior part of the condylar neck, there was a risk of mandibular canal injury on insertion when the angle between the posterior border of the mandible and the mandibular plane was 125 degrees or more. When the pin was aimed towards the inferior part, there was a risk when the angle was 105 degrees or more. When the angle was 130 degrees or more, the risk of the injury was 4 percent when the pin was aimed towards the superior part of the condylar neck, whereas the risk of injury was 25 percent when it was aimed towards the inferior part of the condylar neck. An acceptable cutoff value of the angle of insertion when the pin was amied towards the superior part of the condylar neck was 125 degrees, and that when the pin was amied towards the inferior part was 120 degrees.
Databáze:	OpenAIRE
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