Clinical Observation of Open Reduction & Internal Fixation of Condylar Intracapsular Fracture Assisted by Local Medicinal Chitosan

1. Clinical Observation of ORIF of Condylar
Intracapsular Fracture assisted by Local
Medicinal Chitosan
Under the Guidance of :-
Prof. (Dr.) Li Xiang Jun
Dr.Sun Xu
Presented By:-
Dr.Anas Ameer Khan

2. 1 Introduction to TMJ
2 Movements by TMJ
5
Condylar Fracture
3
Signs & Symptoms
CONTENTS
6
7
Treatment
Medicinal Chitosan
8
A Comparative Study
4 The Conclusion

3. Introduction to TMJ
The temporomandibular joint (TMJ), or jaw
joint, is a synovial joint that allows the
complex movements necessary for life. It is
the joint between condylar head of the
mandible and the mandibular fossa of the
temporal bone. This system is made up of the
TMJ.

4. The complex movements of TMJ allow multiple functions:
 Chewing
 Sucking
 Swallowing
 Phonation
 Facial expressions
 Opening the mouth
 To maintain the correct
pressure of the middle
ear.
 Breathing
 Protrusion
 Retrusion
 Lateralization of the jaw
These movements are constrained by various passive factors, as well as passive tension
of the ligaments and muscles.
Dysfunction of the TMJ can cause severe pain and lifestyle limitation.

5. Facial Expressions Movements

6. Movements of TMJ

7. Condylar Fracture

8. Signs & Symptoms
Swelling over TMJ region.
Bleeding from the ear.
Restricted and painful jaw movement.
Gagging of the teeth on the fractured side.
Shortening of the height of the ramus.
Hematoma can be seen downwards and backwards of the ear.
Open Bite becomes progressively worse to the unaffected side.

9. Treatment
1-Reduction
2-Fixation
Open
Reduction
Closed
Reduction
Open
Fixation
Closed
Fixation

10. Fixation
Open Fixation Closed Fixation

11. Medicinal Chitosan
 Chitosan is a naturally occurring marine polysaccharide fiber derived
from a common byproduct of shellfish (crustaceans) processing.
 Chitosan is a safe and reliable polysaccharide polymer
with excellent biocompatibility,degradability and
biological activity.
 It is often used to prevent tissue adhesions
after surgery and has been used in the
conservative treatment of osteoarthropathy.
03
01
02

12. The Therapeutic Effects
of Chitosan Injection
03
02
01 04
It inhibits the proliferation
of fibroblasts.
Reduces scar hyperplasia
after operation,and avoids
the occurrence of adhesion.
Based on its ability to
cross the cartilage surface,
it acts as a mechanical
barrier that inhibits the
release of inflammatory
factors, which relieves
pain.
It promotes the
synthesis of cartilage
extracellular matrix
to regulate the
metabolism of
chondrocytes.
As a viscoelastic supplement,
it reduces the fluidity of joint
synovial fluid to help lubricate
joints.

13. A Comparative
Case Study
 10 Patients with Condyle Fracture
 Open Reduction & Fixation
 Only Postpartum Routine Training
 Curative Effect Measured
 Pain Score Measured
 Joint Bounce Measured
 Degree of Mouth Opening Measured
Control Group
 10 Patients with Condyle Fracture
 Open Reduction & Fixation
 PRT + Inj.Chitosan 1st,2nd,3rd&4th W.
 Curative Effect Measured
 Pain Score Measured
 Joint Bounce Measured
 Degree of Mouth Opening Measured
Observation Group
Objective:
To investigate the clinical effect of reposition and fixation of condylar intracapsular fracture
assisted by intra-articular injection of medicinal chitosan

14. Preoperative CBCT Imaging of Condylar
Intracapsular Fracture
Postoperative CBCT Imaging of Condylar
Intracapsular Fracture
Pre & Post Surgical CBCT
& Photographs

15. Results on Clinical Efficacies,
Pain Score & Joint Bounce
Group
Efficiency
（%）
Pain Score
(%)
Joint
Bounce
（%）
Control Group 70.68 2.710.74 23.16
Observation
Group
89.96 1.620.53 8.78
P Value P<0.05 P<0.05 P<0.05

16. Results on Mouth
Opening
Group 1st Week
(cm)
2nd Week
(cm)
3rd Week
(cm)
4th Week
(cm)
Control
Group
1.380.43 1.420.33 1.870.62 2.260.73
Observation
Group
1.510.25 1.880.17 2.350.56 2.980.44
P value P>0.05 P<0.05 P<0.05 P<0.05

17. Pre & Post Surgical Mouth
Opening Photographs
Observation Group Control Group
One week after Surgery
Two week after Surgery
Three week after Surgery
Four week after Surgery
Observation Group Control Group

18. The Conclusion
01
Intra articular injection of medical chitosan after open reduction and internal
fixation of intracapsular condylar fracture can reduce postoperative pain,
bounce and promote the functional recovery.
02
It shows better clinical effects compared with traditional conservative
treatment.
03
Hence,we hypothesize that surgery combined with postoperative
chitosan injection is effective in the treatment of TMJOA and

19. 感 谢 聆 听 , 有 美 好 的 一 天
In the end, success finds those who struggle to get it.
“ My Dad”