Infection Necrosis After an Extracorporeal Reduction of a Condyle Fracture.

The authors experienced a patient of infection necrosis after an extracorporeal reduction of a condyle fracture and reconstructed it with an iliac bone graft. A 37-year-old man visited with a bilateral condyle fracture and a left para-symphyseal fracture. On the post-trauma third day, an intermaxillary fixation was applied using arch bars. On the post-trauma tenth day, an extracorporeal reduction was carried out. On postoperative day (POD) 7, the amount of the drain was 9 cc and the drain was removed. On POD 9, redness and a pus drain were observed on the operation site. On POD 18, growth of Streptococcus anginosus was observed in a thioglycolate broth. On POD 47, the infected condylar head was removed and reconstructed with an iliac bone graft. On the POD ninth week, the incisal opening was 24 mm. To prevent such infections, necrosis or absorption of reduced and a miniplate-fixed condyle head, the bony defect should be filled completely without exposing any medullary bone. Hematomas should be prevented using a large suction drain until the drain turns serous and eventually diminishes to zero. Finally, aseptic conditions are required in retrieving, assembling, and reinserting the extracorporeal reduced segment by changing the gloves and sufficient disinfectant irrigation. In case a pus discharge appears at the operation site, it would be wise to remove the fixed condyle, the infection source, and replace with healthy bone graft as soon as possible. (C) 2016 by Mutaz B. Habal, MD.

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