Abstract
Objectives
Double puncture arthrocentesis (DPA) of the temporomandibular joint (TMD) is considered an effective preservative option for managing mandibular condylar head fractures. However, the procedure is commonly performed by a traditional “blind” method using anatomical characteristics. In the present study, an ultrasonography (US) device was applied for the treatment of a case with a fractured mandibular condyle.
Methods
A 79-year-old female was diagnosed right side condylar head fracture complaining pain of right TMD and reduced mouth opening range: inter-incisor distance of 20 mm. Since the fracture position was high and inoperable, the decision was made to perform DPA of the TMD. The US probe was positioned parallel and slightly oblique to the major axis of the mandibular ramus. Both the posterior and anterior insertions into the joint space were performed according to the axis mentioned above, which enabled the operator to visualize the entirety of the needle.
Results
The device offered safety and ensured accuracy by providing real-time visual aid to the surgeon. The procedure provided an early increase in the inter-incisor distance (31 mm) and pain relief.
Conclusions
Hence, for the preservative treatment of mandibular condylar head fractures, based on the present study, we recommend US-guided arthrocentesis as a safe, feasible, and effective therapeutic option instead of the conventional “blind” method.
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Data availability
The data of this technical report is available from the corresponding author upon reasonable request.
References
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The Ethical Review Committee of Yamagata University Faculty of Medicine approved this study (Approval no. 2023-S-23). All procedures were conducted in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). Informed consent was obtained from the patient prior to participation in in the study.
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Hemmi, T., Uno, T., Yusa, K. et al. Ultrasound-guided arthrocentesis for condylar head fracture: a technical report. Oral Radiol (2024). https://doi.org/10.1007/s11282-024-00744-8
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DOI: https://doi.org/10.1007/s11282-024-00744-8