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24 The Journal of Craniofacial Surgery & Volume 20, Number 1, January 2009
Copyright @ 2009 Mutaz B. Habal, MD. Unauthorized reproduction of this article is prohibited.
The Journal of Craniofacial Surgery & Volume 20, Number 1, January 2009 Sorg Classification in Condyle Fractures
Copyright @ 2009 Mutaz B. Habal, MD. Unauthorized reproduction of this article is prohibited.
Cenzi et al The Journal of Craniofacial Surgery & Volume 20, Number 1, January 2009
Copyright @ 2009 Mutaz B. Habal, MD. Unauthorized reproduction of this article is prohibited.
The Journal of Craniofacial Surgery & Volume 20, Number 1, January 2009 Sorg Classification in Condyle Fractures
TABLE 4. Types of Condylar Fractures Matched With Early and Late Complications
Type of Complication DF (n = 4) CNF (n = 36) CBF (n = 44) Total (N = 84)
Postsurgical outcome Frey syndrome V V 1 18 (21.4%)
Malocclusion TMJ symptoms V 8 6
Facial asymmetry V 2 V
Broken plate V 1 V
Total V 11 (30.5%*) 7 (16%*)
Final outcome Frey syndrome V V V 16 (17.8%)
Malocclusion TMJ symptoms V 8 6
Facial asymmetry V V V
Broken plate V 1 V
Total V 9 (25%*) 6 (13.6%*)
In parenthesis without asterisk is the percentage of the total number of condylar fractures (i.e., 84), whereas with the asterisk is the percentage of the specific
group of condylar fractures.
jaw opening caused by a displaced condylar head, telescoping of the Although the decision on the type of treatment must depend
proximal and distal fragments with the loss of vertical ramus height on a number of factors, MMF gave good results in most of the
resulting in malocclusion, displaced bilateral subcondylar fractures patients without complications and technical difficulties encoun-
with malocclusion, and a unilateral or bilateral CF with severely tered during the surgical procedures.20 Of course, some complica-
comminuted midfacial fractures.17 tions may arise with any treatment modality, and many of these (e.g.,
The approach to the condylar neck, when indicated, is pain, infection, edema, malocclusion, trismus, ankylosis, extrusion
through the incision in the preauricular region, but also, an approach of the dentition, edema) can occur with either closed or open
from the mandibular angle can be used.18 Plate-and- (2.0 mm) treatment, especially if appropriate physical therapy is not part of the
fixation offers the most effective method of holding an anatomic treatment plan.10
reduction, and the patient should be able to mobilize the mandible In conclusion, the new classification is a simple method to
immediately. In our series, 14 cases were treated, and 2 had an define CFs and can give some elements about the severity of fracture
insufficient occlusal recovery (14% [Table 5]). and risk of associated fractures. It is our understanding, however,
The disadvantages of internal fixation are the limited access that a multicenter study should be performed before the effective-
to the fracture, the risk of damage to the facial nerve, unsightly ness of SORG classification can be clearly stated especially as
scarring, and condylar resorption.19 On the other hand, internal regards treatment modality and clinical outcome.
fixation is advantageous in substantially displaced CFs for which
anatomical reduction is advantageous.10
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Cenzi et al The Journal of Craniofacial Surgery & Volume 20, Number 1, January 2009
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Copyright @ 2009 Mutaz B. Habal, MD. Unauthorized reproduction of this article is prohibited.