Efficacy of locking plates/screw system in mandibular fracture surgery

Application of Anatomically Designed 2-Dimensional V Plate in Management of Mandible Fracture: A Pilot Study

Background

Mandible is the only mobile facial jaw bone and it aides in various functions such as phonation and mastication. Therefore, management of mandible fracture becomes inevitable due to its functional and anatomical importance. Fracture fixation methods and techniques have steadily evolved with various osteosynthesis systems. In this article, we discuss the management of mandible fracture using a newly designed two-dimensional (2D) hybrid V-shaped plate.

Purpose

In this paper, we have evaluated the efficacy of the newly developed 2D V-shaped locking plate in the management of mandibular fractures.

Method

We have assessed 12 cases of different mandibular fractures ranging from symphysis, parasymphysis, angle and subcondylar region. Treatment outcome was assessed both clinically and radiologically at regular intervals with various intraoperative and postoperative parameters.

Result

Results of this study suggest that fixation of mandible fracture with the 2D hybrid V-shaped plate facilitates anatomic reduction and functional stability and carries a low morbidity and infection rate.

Conclusion

The 2D anatomic hybrid V-shaped plate can be a suitable alternative to conventional miniplate and 3D plates as it offers satisfactory anatomic reduction and functional stability. Positioning the plate in relation to the mental nerve and plate adaptation along the angle region are much easier.

Efficacy of locking miniplates in managing mandibular fractures without intermaxillary fixation

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Comparison of 2 mm single locking miniplates versus 2 mm two non-locking miniplates in symphysis and parasymphysis fracture of mandible

INTRODUCTION

The purpose of this study is to compare the efficacy of single 2 mm locking miniplates versus two 2 mm non-locking (conventional) miniplates in symphysis and parasymphysis fracture of mandible.

METHOD

This present study included 40 patients of maxillofacial trauma having mandibular symphysis/parasymphysis fractures in which open reduction and internal fixation is indicated. Patients were selected according to the inclusion criteria and divided into two groups, i.e. Group 1: consisted of 20 patients, requiring open reduction and internal fixation with 2 mm two non-locking titanium plate and Group 2: consisted of 20 patients, requiring open reduction and internal fixation with 2.0 mm single ultra-locking titanium plate. Fracture was then stabilized and postoperative clinical examination was carried out on 3rd day, 1st, 2nd, 4th, and 8th week.

RESULT

Results of this study suggested that the use of single 2.0 mm locking miniplate could be a viable option instead of using two miniplates in anterior mandibular fracture as advocated by Champy, as it provides equally good outcome along with placement of lesser implant material.

DISCUSSION

Single locking miniplates give the advantage of equally good stability and early restoration of function with almost similar results as seen in osteosynthesis with two miniplates. It was also found that less precision was required in plate adaptation when using single locking miniplate. This study suggests that there is not much difference in surgical outcome with the use of either single locking miniplate or two conventional miniplates in anterior mandibular region.