Which of the 37 Plates Is the Most Mechanically Appropriate for a Low-Neck Fracture of the Mandibular Condyle? A Strength Testing

(1) Background: The mandible is the most frequently injured component of the facial skeleton, with 25-45% of mandibular fractures involving the condylar process. This study aims to mechanically compare which plates are most suitable for use in low-neck fractures of the condyle. (2) Methods: Polyurethane mandibular models with simulated low-neck fractures were tested using 37 distinct plate designs. These plates were fabricated from 1 mm thick, grade 23 titanium sheets. The models were then subjected to force tests on a strength machine, and the correlation between applied force and fracture displacement was recorded. (3) Results: For low-neck fractures, XCP side-dedicated 3+5 and ACP-T plates demonstrated strength comparable to that of two straight plates, the current gold standard in osteosynthesis. (4) Conclusions: The Mechanical Excellence Factor (MEF) introduced by the authors provides a more accurate metric for theoretically predicting a plate's mechanical strength compared to the Plate Design Factor (PDF). Eight plate characteristics were utilized to calculate the MEF. Employing the MEF allows for rapid, preliminary validation before undertaking strength tests. Furthermore, the findings of this study can guide the selection of the most durable plate designs for subsequent fatigue testing.

Assessment of temporomandibular joint dysfunction in condylar fracture of the mandible using the Helkimo index

Introduction:

Condylar fractures of the mandible are functionally important fractures as the condyle of the mandible being a part of the temporomandibular joint (TMJ) and can lead to TMJ dysfunction if not properly treated.

Materials and Methods:

This was a cross-sectional study of a total of 33 treated patients with fracture of the mandibular condyle who underwent examination as per the Helkimo index. Their dysfunction was quantified and clinicoepidemiological characteristics were assessed. It was found that majority of our patients were young males involved in a two-wheeler accident. All patients underwent intermaxillary fixation as the minimum treatment and 30% underwent open reduction and internal fixation in addition.

Results:

There was no statistically significant association between the degree of clinical dysfunction and factors such as age, mechanism of injury, type of condyle fracture, presence of other mandible fractures, and surgical procedure. However, dislocation of the mandibular condyle was found to be a negative prognostic factor and all these patients had some degree of dysfunction.

Conclusion:

The overall prevalence of TMJ dysfunction according to the Helkimo index was 90%. About 61% of patients had mild dysfunction (Di1) and 30% had moderate dysfunction (Di2). None of the patients had severe dysfunction. To conclude, the Helkimo index is a simple, effective, inexpensive, reliable screening index to assess TMJ dysfunction in condylar fractures of mandible.